摘要
目的探讨不同手术方法治疗胸腰椎结核的疗效。方法自2006年11月～2010年7月利用不同手术方法治疗16例胸腰椎结核。术前合并髋关节结核1例,合并截瘫者2例(Frankel B级)。双椎体12例,三椎体4例。5例胸椎结核中4例行前路经胸或胸膜外病灶清除、钛笼充填异体骨植入及钉板(棒)内固定术,1例88岁截瘫患者采用后路椎板切除减压术;3例胸腰椎结核和8例腰椎结核选择前路病灶清除、植骨或不植骨及后路椎弓根钉内固定术。随访时间0.5～3.5年,平均1年2个月。结果术后3例发生并发症,1例88岁截瘫患者围手术期因心功能衰竭死亡,2例分别于术后1个月和2个月复发形成窦道,行再次清创及局部灌洗引流后治愈。末次随访时13例X线片显示植骨融合,2例显示植骨大部分融合,后凸畸形得到部分矫正。另1例术前截瘫者恢复至Frankel D级。结论治疗胸腰椎结核应依病变部位和范围的不同采用不同手术方法,术后灌洗引流可以有效地避免复发,对于复发患者再次清创及局部灌洗引流仍是有效的方法。
Objective To investigate perioperative features and results of surgical treatment of thoracic and lumbar vertebrae tuberculosis. Methods The clinical data of 16 cases of thoracic and lumbar vertebrae tuberculosis was reviewed from November 2006 to July 2010 ret-rospectively. The average age was 67.5 yearsold.One patient had the complications of hip tuberculosis and another with paralysis （Frankel B）.The surgical procedures included anterior debridement and bony grafting with anterior instrumentation fixation in 4 patients,anterior debridement and bony grafting with posterior fixation in 11 patients. The mean followed-up period was 1 year and 2 months （from 0.5 to 3.5 years）.Results One 88 years old patient died one day after the operation.Tuberculosis infection was controlled in 2 patients without recurrence. Bone fusion was achieved in 13 patients.The deformity was partially corrected at the final follow-up.Conclusions Thoracic and lumbar vertebrae tuberculosis should be treated with different methods according to its region and site. Postoperative irrigation and draining could avoid recurrence of tuberculosis efficiently, which is also effective to the recurrent cases.
出处
《中国骨与关节损伤杂志》
2011年第3期197-199,共3页
Chinese Journal of Bone and Joint Injury
关键词
结核
胸腰椎
外科手术
内固定
Tuberculosis
Thoracic and lumbar vertebrae
Surgical procedures
Internal fixation
