前后联合手术入路治疗腰骶段脊柱结核35例临床分析  

作　　者：高金楼 

机构地区：[1]聊城市传染病医院,山东252000

出　　处：《当代医学》2015年第6期29-30,共2页Contemporary Medicine

摘　　要：目的：探讨腰骶部脊柱结核通过前后联合手术入路行病灶清除一期椎间植骨融合加内固定的治疗疗效。方法选取采用前路病灶清除、植骨加后路内固定治疗腰骶段脊柱结核35例，病变均位于腰骶段，累及到2个椎体30例（L 4～519例，L 5～S 111例），累及到3个椎体（L 4、L 5和S 1）5例，该手术方式适用于L 4～S 1脊柱结核，所选病例均伴有脓肿形成，13例伴有不同程度的神经压迫症状。术前腰骶椎前凸消失或后突畸形，35例均一期手术完成。结果本组35例患者均获得随访，随访时间8～30个月，平均随访2年，切口均愈合良好，术后腰骶椎后突畸形消失，植骨融合率100%，疗效优良率97%，术后无1例复发。结论前后联合入路手术行病灶清除一期椎间植骨融合、内固定主要适用于L 4～S 1椎体结核，该术式有利于清除病灶、恢复脊柱的稳定性，提高植骨融合率，矫正后突畸形。Objective To investigate effect of the lumbosacral spine tuberculosis through lesion clearanceissue of intervertebral bone graft fusion and internal ifxation by combined anterior and posterior approaches. Methods Form September 2007 to December 2012,35 patients with anterior debridement, bone grafting and internal fixation in the treatment of tuberculosis of lumbosacral spine, the lesions were located in the lumbosacral.There were 30 cases of 2 vertebral bodies （L 4-5 19 cases, L 5-S 1 11 cases） and 5 cases of 3 vertebrae （L 4,L 5,S 1）, the operation method is suitable for L 4-S 1 spinal tuberculosis.The selected cases with abscess formation, and 13 cases of nerve compression symptoms in different degree. The 35 patients who were with lumbosacral lordosis disappear or deformity before surgery had completed the one-stage operation. Results All patients were followed up for 8 to 30 months. An average follow-up of 2 years, all patients incision healed well and the postoperative lumbosacral vertebral kyphosis disappeared and the fusion rate was 100% and the instant efifcacy rate was 97%.There was no one had a relaps. Conclusion Lesion clearanceissue of intervertebral bone graft fusion and internal ifxation by combined anterior and posterior approaches is mainly suitable for the L 4-S 1 vertebral body.The operation helps to clear the focus and the recover stability of spine.It also can improve the fusion rate of bone graft and correct kyphosis.

关 键 词：腰骶段脊柱结核 病灶清除术 植骨 内固定 

分 类 号：R687.3[医药卫生—骨科学]