带血管蒂肋骨或髂骨椎间植骨治疗胸腰椎结核  

Vascularized Rib or Iliac Bone Graft in Treatment of the Tuberculosis of Thoracolumbar Spine

作　　者：刘祥清 李洪恩 许屾 张印峰 李国建 高伟 徐昌健 

机构地区：[1]枣庄矿业集团公司枣庄医院骨科,山东枣庄277101

出　　处：《解剖与临床》2006年第4期242-244,共3页Anatomy and Clinics

摘　　要：目的：探讨胸腰椎结核病灶清除术后带血管蒂的肋骨或髂骨椎间植骨的疗效。方法：手术治疗胸腰椎结核22例，首先清除病灶，其后T5～T11结核10例及T12～L1结核4例采用带肋间血管蒂的肋骨椎间植骨，L2～L5结核8例采用带旋髂深血管蒂髂骨椎间植骨。结果：本组22例术后均在2．5～3个月内愈合。随访7个月～17a，平均32．4个月，无复发。合并不全瘫的3例胸椎结核，半年后均已恢复。结论：带血管蒂肋骨或髂骨椎间植骨为活骨移植，其血运丰富，愈合快，是治疗胸腰椎结核的有效方法。Objective：To investigate the therapeutic effect of vascularized rib or iliac bone graft in treatment of tuberculosis of thoracolumbar spine after lesion excision. Methods：22 cases with tuberculosis of thoracolumbar spine were firstly treated by lesion excision and then, 10 cases with T5 - T11 TB and 4 T12 - L4 TB received vascularized rib grafts in interbody,8 L2 -L5 TB were performed by iliac bone grafts with deep iliac circumflex vessels. Results：22 cases performed by vascularized bone grafts, returned to outpatient clinic 2 - 6 times average of 2.9 times after discharge from hospital for interview. Their bone fusions occurred within 2.5 - 3 months postoperative. The mean periods of follow- up were from 7months to 17 years, averaged 32.4 months, without recurrence. 3 cases of thoracic spine TB with partial paraplegia recovered in 6 months after operation. Conclusion： The vascularized rib or iliac bone grafts have intact periosteum and blood supply,so the bone fusions were better than that of dissociated interbody bone grafts. It is an effective and reliable technique for treating the tuberculosis of thoraeolumbar spine.

关 键 词：脊柱 结核 肋骨瓣 髂骨瓣 移植 

分 类 号：R687.3[医药卫生—骨科学]