摘要
目的探讨前路病灶清除，一期植骨钛钢板内固定治疗胸腰椎结核的疗效。方法2000—05／2005—06采用前路病灶清除，一期植骨钛钢板内固定治疗胸腰椎结核52例。男32例，女20例，年龄21～65岁，平均38岁。影像学显示单椎体破坏塌陷9例，双椎体破坏塌陷楔形变43例，脊柱后凸畸形35例，cobb’s角14～41°，平均24°。不全截瘫19例。血沉40～110mm／h。术前抗结核药物治疗2-4周。术后继续抗结核药物治疗10～12个月。结果切口均一期愈合，随访1．2～4年，平均2．2年。植骨块6～7月融合，无移位，折断和吸收。19例不全截瘫者术后2～4月恢复到E级。35例脊柱后凸角度平均矫正14°。血沉于术后3～5月恢复到正常。随访期内结核病灶无复发。结论前路病灶清除、一期髂骨植骨钛钢板内固定是治疗脊柱结核较安全有效的治疗方法。
Objective To discuss the clinical efficacy in treating the thoracolumbar spinal tuberculosis with radical debridement, iliac grafting and internal fixation. Methods 52 patients with thoracolumbar spinal tuberculosis were treated by anterior radical debridement of the diseased vertebrae, iliac grafting and internal fixation from May 2000 to Jun. 2005. There were 32 males and 20 females and mean age was 38 years old （21-65 years old）. 35 patients had spinal kyphosis deformity with Cobb＇ s angles of the thoracolumbar spine were ranged from 14°-41° （average of 24°）. Their ESR ranged from 40-110mm/h. 19 patients had Inparaplegia. All patients received anti - tubercolosis chemotherapy for 2-4 weeks before operation . Anti - tuberculosis chemotherapy was given regularly for 10- 12 months after surgery . Results All patients were followed up for 1.2-4 years （average 2.2 years）. The wound healed after surgery. The graft fused in 6-7 months after surgery and 19 paraplegia patients recovered completely in 2-4 months after operation and 35 cases with kyphosis was corrected partly. The ESR of these patients decreased to a normal level in 3 to 5 months after surgery. Conclusions Anterior radical debridement with iliac grafting and internal fixation is an effective therapy in curing the spinal tuberculosis.
出处
《职业卫生与病伤》
2006年第3期180-182,共3页
Occupational Health and Damage
关键词
胸腰椎结核
前路手术
髂骨植骨
内固定
Thoracolumbar spinal tuberculosis
Anterior operation
Iliac grafting
Internal fixation
