摘要
目的探讨高龄颈椎结核合并四肢瘫外科治疗的临床疗效与安全性。方法对8例高龄颈椎结核合并四肢瘫患者采用早期前路病灶清除、减压、植骨、内固定手术，并行联合化疗。术前Frankel瘫痪分级：B级2例，C级5例，D级1例。结果术后随访4～36个月，平均8个月，死亡2例：1例术后4个月死于突发肺部感染，1例2年后死于脑血管意外。所有患者术后脊髓功能均有不同程度恢复，Frankel分级D级3例，E级5例。4～6个月X线片显示无骨质破坏复发，植骨处均已骨性融合，无内置物松动、脱落或断裂。结论高龄颈椎结核合并四肢瘫宜在联合化疗的基础上尽早外科干预；在周到、细致的围手术期管理、正确熟练的手术操作技术下，颈前路病灶清除、减压、植骨、内固定治疗高龄颈椎结核并四肢瘫是安全有效的。
Objective To study the clinical outcome and security of surgical treatment of senile cervical tuberculosis with quadriplegia. Methods 8 cases of cervical tuberculosis with quadriplegia were treated by anterior cervical discectomy, fusion, internal fixation, and combined with antiotuberculosis medicine treatment. The function of spinal cord were graded by Frankel criteria：2 B, 5 C and 1D. Results The follow-up periods ranged from 4 to 36 months, averged 8 months. 2 patients died： 1 died of acute pneumonia after 4 months, and the other died of cerebrovascular accident after 2 years. The function of spinal cord improved markedly. 5 cases were improved to D,5 to E. No recurrence was found. Bony fusions were presented in 4 -6 months postoperativly. No fixation failure and recurrent slip were found. Conclusions Combined with antiotuberculosis medicine treatment, surgical treatment should be done in earlier period on senile cervical tuberculosis with quadriplegia;With a thoughtful management surround the operation and a practised technique,anterior cervical discectomy,fusion and internal fixation were safe and effective.
出处
《临床骨科杂志》
2007年第1期13-15,共3页
Journal of Clinical Orthopaedics
关键词
颈椎
结核
脊柱/外科学
四肢麻痹
cervical vertebre
tuberculosis, spinal/surgery
quadriplegia
