侧前方病灶清除人工椎体置换术治疗胸椎结核后凸畸形  

Treatment of the thoracic tuberculosis with kyphosis by removing front-side focus and replacing the artificial vertebra

作　　者：耿云光 祖太坤 宋平 

机构地区：[1]辽宁省锦州市结核病医院骨科,121017

出　　处：《中国脊柱脊髓杂志》2005年第4期229-231,共3页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨脊柱侧前方病灶清除椎间轴套式钛合金人工椎体置换治疗胸椎结核并后凸畸形的疗效。方法:胸椎结核并后凸畸形患者19例,后凸Cobb角15°～30°,平均25°,7例患者合并脊髓压迫,Frankel分级C级3例,D级4例。手术方法为一期侧前方病灶清除椎间轴套式钛合金人工椎体置换,置换的人工椎体内置入松质骨。术后抗结核药物治疗9个月。结果:随访2～3年,平均2年4个月。切口均一期愈合,椎体无滑脱,胸椎结核全部治愈,脊髓功能损害者术后1年内完全恢复。术后后凸Cobb角平均8°,平均矫正17°,随访期间畸形矫正无明显丢失。结论:胸椎结核侧前方病灶清除人工椎体置换术治疗胸椎结核并后凸畸形效果较好,能够一期完成病灶清除、脊髓减压、脊柱稳定性重建和后凸畸形矫正。Objective:Approach the curative effect of treating the thoracic tuberculosis with kyphosis by removing front-side focus of the spinal column and displacing the vertebra with the artificial vertebra of axle-sleeve type titanium alloy between the vertebras.Method:19 cases of the thoracic tuberculosis with kyphosis,Cobb′s angle was 15°-30°,average angle was 25°.7 cases of the patients had spinal compression,Frankel grade was that 3 cases with grade C,4 cases with grade D.The operating technique was one-stage operation,by removing front-side focus and displacing the vertebra with the artificial vertebra of axle-sleeve type titanium alloy between the vertebras,spongy bone was placed in the artificial vertebra.After the patients had been operated,the antituberculotics must be used for 9 months.Result:The patients were followed up for 2-3 years,the average was 2 years and 4 months.The incision was primary union,no sliding detachment of the vertebra,the tuberculosis of the thoracic vertebra had been all cured,the function of the spinal cord of the patients had been convalesced fully within 1 year.After the operation,Cobb′s angle of kyphosis was in an average of 8°,the average correction was 17°.During follow-up,the corrected kyphosis was not distinctly lost.Conclusion:The treatment of the thoracic tuberculosis with kyphosis by removing front-side focus and displacing the vertebra with the artificial vertebra can be completed in one-stage operation.

关 键 词：胸椎 结核 后凸畸形 人工椎体 

分 类 号：R529.2[医药卫生—内科学] R682.3[医药卫生—临床医学]