前路病灶清除椎间植骨短节段内固定治疗胸腰椎结核  

Anterior debridement,interbody autografting fusion and short segment internal fixation in surgical management of thoracolumbar tuberculosis

作　　者：黄吉林[1] 胡豇[2] 胡云洲[3] 王彦川[3] 

机构地区：[1]成都市第四人民医院,四川成都610036 [2]四川省人民医院,四川成都610072 [3]成都市第七人民医院,四川成都610041

出　　处：《西部医学》2012年第8期1490-1492,共3页Medical Journal of West China

摘　　要：目的探讨前路病灶清除椎间植骨短节段内固定治疗胸腰椎结核的临床效果。方法对36例胸腰椎结核并获得完整随访资料的患者采用一期前路病灶清除、自体骨植骨、钛钢板短节段内固定治疗。结果切口一期愈合30例,延期愈合6例。随访1～5年,平均2.6年。15例脊柱后凸角度平均矫正12°。椎间植骨6～8个月均获骨性融合,植骨块无移位和吸收,9例不全截瘫者术后9～16个月完全恢复,随访期内钢板螺钉无松动、脱出与折断,结核病灶无复发。结论胸腰椎结核行前路病灶清除、自体骨植骨钛钢板短节段内固定可有效矫正后凸畸形,重建脊柱稳定性,获得骨性融合,临床效果良好。Objective To study the clinical outcome in treating thoracolumbar tuberculosis with debridement,autografting and internal fixation.Methods 36 patients with thoracolumbar tuberculosis were treated by anterior debridement of the diseased vertebrae,autografting and short segment internal fixation.There were 21 males and 15 females and age was 18~ 59years old.2 verrtebral bodies involved in 23 cases,3 vertebrnal bodies involved in 13 cases.15 patients had spinal kyphosis deformity with Cobb’s angles of the spine were ranged from 11°~ 25°.8 patients had inparaplegia.Results All patients were followed up for 1~4 years（average 2.1 years）.Their lesion was completely eliminated.The wound healed after surgery.The graft fused 5~7 months after surgery.The internal fixation not loosely breaks off.14 cases with kyphosis was corrected partly,average of 12°.9 patients with inparaplegia recovered to the normal in 9-16 months.There was no recurrence within follw-up period in all the patients.The internal fixation not loosely breaks off.Conclusion For patient with thoracolumbar tuberculosis,anterior debridement with autografting and internal fixation appears to be effective in correcting spinal kyphocis,recomstructing the stability of spine and improving clinical outcome.

关 键 词：胸腰椎结核 病灶清除 自体骨植骨 内固定 

分 类 号：R529.2[医药卫生—内科学]