前路病灶清除、植骨、内固定治疗脊柱结核  

Anterior Radically Debridement,Allografts and Internal Fixation for the Treatment of Spinal Tuberculosis

作　　者：罗晓中[1] 唐玉湖[1] 王绍珍[1] 谭伦[1] 

机构地区：[1]自贡市第四人民医院骨科,四川自贡643000

出　　处：《实用骨科杂志》2005年第6期492-494,共3页Journal of Practical Orthopaedics

摘　　要：目的观察前路病灶清除、植骨、前路或后路内固定治疗脊柱结核的效果.方法总结1997年1月至2004年6月采用前路病灶清除、植骨、前路或后路内固定治疗脊柱结核41 例,病变位于颈椎3 例、胸椎3 例、胸腰椎20 例、腰椎14 例、腰骶椎1 例,术前有后凸成角畸形9°～71°,平均32°.Ⅰ期前路病灶清除、植骨、内固定31 例,Ⅰ期前路病灶清除、植骨、后路内固定6 例,Ⅱ期后路内固定4 例.结果平均随访1.6 a,优良率为87.8%,植骨融合率为92.7%,平均矫正后凸角度15.3°(P<0.05),随访期间无1 例复发.结论前路病灶清除、植骨、前路或后路内固定治疗脊柱结核有利于恢复脊柱的早期稳定性,融合率高,可预防及矫正脊柱后凸畸形.Objective To evaluate anterior debridement, allografts, anterior or posterior internal fixation for the treatment of spinal tuberculosis. Methods 41 cases of the spinal tuberculosis were treated with anterior radically debridement, allografts and internal fixation. The lesson were located at cervical spine in 3 patients, thoracic spine in 3 patients, thoracolumbar spine in 20 patients, lumbar spine in 14 patients and lumbosacral spine in 1 patients. The preoperative kyphosiswere 9- 71degrees with a mean of 32 degrees. 31 cases of these were treated by anterior internal fixation in first stage, 6 cases were treated by posterior internal fixation in first stage, and 4 cases were treated by posterior internal fixation in second stage. Results The average followed-up time was 1.6 years. 87.8% of the pauents had good results and 92.7% had solid fusion. 15.3 degrees of kyphosis correction was achieved and the difference between preoperative and postoperative kyphosis is apparently（P〈0. 05）. There were no cases of recurrence during the followed up time. Conclusion Spinal tuberculosis treated with this sugrical technique can achieve a high satisfactory rate with restoring the spinal stability, providing early fusion, preventing and correcting progression of the kyphosis.

关 键 词：脊柱结核 病灶清除术 脊柱融合术 内固定 

分 类 号：R529.2[医药卫生—内科学]