摘要
目的:探讨病灶清除单节段植骨融合内固定治疗脊柱结核的适应证及疗效。方法:2003年6月～2009年6月共收治单运动节段脊柱结核患者41例,术前常规抗痨2～4周后行病灶清除、单节段植骨融合、器械内固定术,术后应用超短程化疗方案。随访观察患者的后凸Cobb角、血沉(ESR)及C-反应蛋白(CRP)的变化情况,结合植骨融合、Frankel分级进行综合评价。结果:随访12～78个月,平均29.2个月。术前、术后、末次随访时后凸Cobb角分别为21.7°±9.8°、9.5°±8.4°和11.3°±9.1°,术后平均矫正12.2°±5.8°,末次随访时丢失1.8°±1.0°,矫正率和丢失率分别为56.2%和8.3%。至术后6个月时ESR及CRP异常者均恢复至正常。所有患者术后4～6个月(平均5个月)均达到植骨愈合;17例神经功能障碍者末次随访时Frankel分级均达到E级。结论:单节段植骨、内固定可有效地恢复和维持脊柱的稳定性,可用于治疗有适应证的单节段脊柱结核。
Objective：To investigate the clinical efficacy of single segment fusion and instrumentation for spinal tuberculosis after debridement.Method：41 patients with spinal tuberculosis of single segment involvement underwent anterior debridement,bony grafting and single segment instrumentation from June 2003 to June 2009.Ultra-short-course chemotherapy was carried out postoperatively and all cases were followed up.The changes of the Cobb angle,ESR and CRP of all patients were documented.Comprehensive evaluation of fusion status and Frankel grade were also performed.Result：The average follow up was 27.1 months （range,12-84 months）.The kyphotic Cobb angle at preoperation,postoperaton and final follow up was 21.7°±9.8°,9.5°±8.4° and 11.3°±9.1° respectively,with the average correction of 12.2°±5.8° and loss of correction of 1.8°±1.0° at final follow up,the rate of correction and loss of correction was 56.2% and 8.3%.At 6 months after operation, the patients with abnormal ESR and CRP had them recovered to normal.All patients had bony union till 4-6 months（average,5 months）,and all patients had neurological function and daily activity returned to normal.All patients had neurofunction recovered to grade E at final follow-up.Conclusion：Single segment fusion and instrumentation can maintain the alignment and stability,which is indicative to single-segment spinal tuberculosis.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2010年第10期811-815,共5页
Chinese Journal of Spine and Spinal Cord
关键词
脊柱结核
内固定
单节段
Spinal tuberculosis Internal fixation Single segment
