一期后路病灶清除、椎体间钛笼植骨椎弓根钉内固定治疗胸椎结核  

Titanium mesh filled with bone graft combined with pedicle screw fixation after posterior debridement for treatment of thoracic tuberculosis on first stage

作　　者：赵敏[1] 张立[1] 许建中[2] 吕仁发[1] 陈超[1] 史柏娜[1] 周江军[1] 

机构地区：[1]解放军第184医院骨科二病区,江西鹰潭335000 [2]第三军医大学西南医院骨科,重庆400038

出　　处：《临床骨科杂志》2012年第3期251-252,255,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨一期后路病灶清除、椎体间钛笼植骨、椎弓根钉内固定治疗胸椎结核的临床效果。方法对21例胸椎结核患者采用一期后路病灶清除、椎体间钛笼植骨椎弓根钉内固定治疗,术后抗结核药物治疗9～12个月。对患者术前、术后行影像学检查,测量Cobb角以及评价神经功能Frankel分级。结果患者均获随访,时间12～48个月。钛笼植骨平均融合时间6～9(7.8±1.2)个月;Cobb角由术前31°～61°(41.8°±8.2°)矫正至术后10°～29°(21.6°±5.6°)。18例有神经功能障碍者术后15例获得1级以上的恢复。结论一期后路病灶清除椎体间钛笼植骨椎弓根钉内固定治疗胸椎结核可取得较好疗效。Objective To investigate the curative effect of titanium mesh filled with bone graft combined with pedicle screw after posterior debridement for treatment of thoracic tuberculosis on first stage. Methods 21 thoracic tuberculo- sis cases were treated by titanium mesh filled with bone graft combined with pedicle screw after posterior debridement for treatment of thoracic tuberculosis on first stage and antituberculous drugs therapy 9 - 12 months on second stage. All patients were evaluated by X-Ray, CT and MRI, Cobb＇s angle and Frankel classification. Results All cases were follow up for 12 -48 months. The average fusion time was 6 - 9（7.8 ± 1.2） months. The Cobb＇s angle was 10° - 29°（21.6° ±5.6°） after surgery while 31°-61°（41.8°± 8.2°） before surgery. 18 cases with nerve functions disability were recovery exceed 1 degree. Conclusions Titanium mesh filled with bone graft combined with pedicle screw after posterior debridement for treatment of thoracic tuberculosis on first stage can result in better therapeutic outcome.

关 键 词：胸椎结核 钛笼 内固定 融合 植骨 

分 类 号：R529.23[医药卫生—内科学] R687.32[医药卫生—临床医学]