人工椎体置换治疗胸腰椎结核的临床疗效观察  

Clinical Analysis of Artificial Vertebral body in Treatment for Tuberculosis of Thoracic and Lumber Vertebrae

作　　者：谢晓勇[1] 李平生[1] 李玉茂[1] 林松龄[1] 赵勇[1] 蔡奋忠[1] 宋毓鸿[1] 林奇益[1] 

机构地区：[1]南京军区福州总医院95临床部骨科,福建省莆田市351100

出　　处：《中国骨与关节损伤杂志》2008年第11期890-892,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨人工椎体置换治疗胸腰椎结核的临床疗效。方法回顾性分析胸腰椎结核28例,其中累及1个椎体5例,2个椎体22例,3个椎体1例。对该组患者行椎体大部切除,撑开复位后行可调式中空笼状钛合金人工椎体植骨置换、前路椎体钉棒系统邻近椎节固定,观察术后局部疼痛缓解、脊柱稳定性及后凸畸形的矫治情况。结果所有患者术后疼痛缓解,切口均一期愈合,随访12～36个月,平均17个月,局部无复发,影像学检查椎体序列恢复良好,椎间高度恢复,达到骨性愈合,后凸畸形基本矫正。结论胸腰椎结核行人工椎体置换,既能彻底切除病灶防止复发,又能矫正畸形,有效重建脊柱稳定性,恢复脊柱支撑功能。Objective To investigate the efficacy of artificial vertebral body in the treatment of tuberculosis （TB） of thoracic and lumbar spine. Methods Twenty - eight patients with tuberculosis of thoracic and lumbar spine were retrospectively analyzed. One vertebra was involved in 5 patients, 2 vertebrae in 22 patients, and 3 vertebrae in 1 patient. All patients were treated by focus resection through anterior approach in first intention, implant adjustable hollow titanium artificial vertebral body, internal fixation with XIA in anterior approach. Relief of the pain, spinal stability and kyphosis collection were observed. Results All patients had their incision healed by first intention. The pain was relieved after surgery, followed up from 12 to 36 months （mean 17 months）. No TB recurrence occurred. Postoperative radiological evaluation revealed that implants were stable. There was no phenomena of prosthesis subsidence, hook dislodgment and failure restoration of spinal segments height. Solid bony fusion was obtained in all patients. The kyphosis was corrected obviously. Conclusion Operation of artificial vertebral body in treatment of TB of thoracic and lumber vertebrae can cure tuberculosis without recurrence and can also correct deformity, and strengthen the spinal structure.

关 键 词：人工椎体 胸腰椎 结核 手术治疗 

分 类 号：R738[医药卫生—肿瘤] R529.2[医药卫生—临床医学]