侧前路一期病灶清除植骨内固定治疗腰椎结核  

Anterolateral debridement,bone graft and internal fixation for lumbar vertebra tuberculosis

作　　者：罗成辉[1] 赵万恒[1] 符江[1] 

机构地区：[1]凉山州第二人民医院,四川西昌615000

出　　处：《医学信息（中旬刊）》2011年第5期1714-1715,共2页Medical Information Operations Sciences Fascicule

摘　　要：目的：探讨侧前方入路一期病灶清除、取髂骨植骨、钉板系统内固定治疗腰椎结核的手术方法及效果。方法：52例腰椎结核患者。术前四联抗结核治疗2周后，采取侧前方入路行一期病灶清除、前路减压、取髂骨植骨及钉板系统内固定术治疗。结果：患者均能耐受手术，术中显露清楚，病灶清除彻底。手术时间为120—180rain，术中出血量为700—1200ml，无手术并发症发生。术后后凸矫正10°-30°。术后患者的自觉症状均有改善。52例患者都进行随访工作，随访时间为12—36个月，在进行最后一次随访时27例患者合并有神经系统症状的患者，进行Frankel分级，3例C级的患者有1例恢复到D级，另外2例恢复到E级的水平。24例D级的患者都恢复到E级的水平。患者没有出现复发的情况，没有出现断钉等并发症。椎间植骨都得到了融合，融合的时间5个月至9个月。结论：经侧前方入路一期病灶清除、取髂骨植骨、钉板系统内固定手术是治疗腰椎结核的有效治疗方法，其有患者可早期下地活动、预防植骨块移位、稳定脊柱、矫正畸形等特点。Objective：To assess the efficacy of bone graft fusion and anteriolateral spinal stabilization as an alterna - Live treatment for lumbar vertebra tuberculosis. Methods：52 patients with tuberculosis of the lumbosacral region un - denvent anterior decompreasion,iliac bone graft fusion and screw - plate system fixation after antituberculosis medica - tion with four kinds of drugs combined chemotherapy for at least two weeks preoperatively. Results：All patients stoedsurgery well. The operation time was 120 - 180min and the bleeding during operation was 700 - 1200ml. There wasno postoperative complication. After surgery ,pain relief was seen in all patients. The angle correction was 100 N 300postoperatively. All patients were followed up for 18 -36 months. At the last folio - up visit, 1 patient, vith FrankelGrade C improved to Grade D ,2 patient with Grade C improved to Grade E ,24 patients with Gr - ade D improved toGrade E. There was no breakage or failure of the internal fixation during the foIJow up. Stable bone union was ohservedin all cases and the time required for fusion was 5 - 9 months. Conclusions： Lumbar vertebra tuberculosis treated with this Surgical technique can achieve a high satisfactory rate in restoring spinal stability,providing early fusion,cot -recting and preventing progression of lordosis.

关 键 词：腰椎结核 病灶清除术 植骨 脊柱融合术 

分 类 号：R529.205[医药卫生—内科学]