一期后路经椎弓根病灶清除、植骨融合、内固定治疗老年胸腰椎结核  

One stage posterior transpedicular debridement,fusion and pedicle screw fixation to treat elderly thoracolumbar spinal tuberculosis

作　　者：吕晓强[1] 张永进[1] 杜英勋[1] 周方伦[1] 

机构地区：[1]温州医学院附属东阳医院骨科,浙江东阳322100

出　　处：《临床骨科杂志》2011年第4期364-366,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨一期后路经椎弓根病灶清除、植骨融合、内固定术治疗老年胸腰椎结核的疗效。方法 15例老年胸腰椎结核患者,经正规抗结核治疗2周以上,行一期后路经椎弓根病灶清除植骨融合、椎弓根钉内固定。观察手术时间、术中出血量、术后神经功能恢复及植骨融合和脊柱序列保持情况。结果手术时间为（140±21）min,术中出血量为（500±88）ml。15例均获随访,时间24~36个月。神经功能Frankel分级：5例D级恢复到E级4例,1例无恢复。植骨均融合。术后脊柱后凸、侧凸均有不同程度纠正,Cobb角术后为0°~24.2°,末次随访时为0°~25.3°。结论采用一期后路经椎弓根病灶清除、植骨融合、内固定治疗老年胸腰椎结核,创伤小、效果好,但应严格把握手术适应证。Objective To evaluate the efficacy and indications of the one stage posterior transpedicular debridement,fusion,and internal fixation to elderly thoracolumbar spinal tuberculosis.Methods 15 cases of elderly patients with thoracic and（or） lumbar tuberculosis by regular anti-TB treatment for 2 weeks were operated with one stage posterior transpedicular debridement,fusion and pedicle screw fixation.The operation time,blood loss,postoperative recovery of neurological function,fusion and the sequence recovery of the spine were observed.Results The operation time was（140±21） minutes,and the blood loss was（500±88） ml.Fifteen patients were followed up for 24～36 months,4 patients with neurological disorders recovered from Grade D to Grade E,1 D level did not recovered;the graft bone was fusion.Scoliosis were all corrected with the difference of degree,and the Cobb angle was 0°～24.2° after operation and 0°~25.3° at final followup.Conclusions The operation of one stage posterior thoracolumbar spinal tuberculosis is effective and less invasive,but surgical indications shoulded be strictly controlled.

关 键 词：结核 脊柱 病灶清除 内固定 植骨 脊柱融合术 

分 类 号：R529.2[医药卫生—内科学] R687.32[医药卫生—临床医学]