经肋椎关节手术入路治疗胸椎多椎体结核的临床研究  

Costovertebral joints approach surgical treatment of multiple thoracic vertebral tuberculosis

作　　者：官众[1] 许勇[1] 任磊[1] 李得春[1] 彭兴国[1] 

机构地区：[1]青海大学附属医院脊柱外科,青海810001

出　　处：《脊柱外科杂志》2013年第6期337-340,共4页Journal of Spinal Surgery

摘　　要：目的 探讨后路经肋椎关节入路病灶清除、内固定、植骨融合治疗胸椎多椎体结核的临床效果.方法 回顾分析2005年7月~2011年7月,采用后路经肋椎关节病灶清除、内固定、植骨融合手术治疗的胸椎多椎体结核患者43例,术前及末次随访时行Frankel评分,观察随访期间植骨融合率、后凸畸形矫正状况.结果所有患者均获得随访,时间7个月~5年,末次随访时1例Frankel A级患者恢复至Frankel D级,3例Frankel B级患者恢复至Frankel D级,其余患者均恢复至Frankel E级.随访期间所有患者均取得骨性融合,融合时间3~12个月.术后1周Cobb角平均为5.1°,末次随访Cobb角平均为9.2°,Cobb角平均丢失约4.1°.结论 经肋椎关节手术入路治疗胸椎多椎体结核是一种较为理想的手术方式.Objective To assessment the curative effect of costovertebral joints approach treatment of thoracic tuberculosis by debridement, intern°°al fixation and bone graft fusion. Methods A total of 43 patients with multiple thoracic vertebral tuber-culosis treated by posterior pedicle fixation, debridement and bone graft fusion through costovertebral joints approach from July 2005 to July 2011 were involved in this retrospective analysis. Results The Frankel classification, fusion rate and kyphosis correction were undertaken before surgery and at the final follow-up. All the cases were followed up from 7 months to 5 years. At the final follow-up, 1 case of Frankel A turned to D, 3 cases of Frankel B turned to D, and the rest all returned to E. All cases got nice fusion. The fusion periods were 3 ° 12 month. The mean Cobb＇ s angle of postoperative 1 week was 5.1°, the mean Cobb＇ s angle at final follow-up was 9.2°, and mean loss of Cobb＇ s angle was about 4.1 °. Conclusion Posterior pedicle system fixation combined with bone fusion treatment through costovertebral joints approach can strengthen the stability of the spine, promote bone fusion and rectify the kyphosis.

关 键 词：胸椎 结核 脊柱 清创术 内固定器 脊柱融合术 

分 类 号：R529.23[医药卫生—内科学]