单纯自体髂骨块植骨与钛网植骨在胸腰椎结核治疗中的应用  

Application of autogenous iliac bone graft alone and iliac bone graft associated with titanium mesh on thoracolumbar spinal tuberculosis treatment

作　　者：李虎进[1] 赵晨[1] 黄兴舟 侯天勇[1] 张泽华[1] 许建中[1] 周强[1] 

机构地区：[1]第三军医大学附属西南医院骨科,重庆400038

出　　处：《中国医学前沿杂志（电子版）》2015年第3期120-124,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的：探究单纯自体髂骨块植骨与钛网植骨治疗胸腰椎结核的临床效果。方法回顾性分析本院2007年2月至2013年1月采用彻底病灶清除、植骨融合内固定术治疗的67例胸腰椎结核患者，其中单纯自体髂骨块植骨融合内固定术31例（A组），钛网植骨融合内固定术36例（B组）。比较两组患者手术前后美国脊髓损伤协会（ASIA）评分分级、Cobb角及末次随访丢失情况、植骨融合率、手术时间、术中出血量、住院天数及术后引流量。结果所有患者随访时间为22～53个月，平均39.5个月。两组患者术后神经功能较术前均有改善，但差异无显著性（P＞0.05），术后Cobb角较术前明显减小（P＜0.05），末次随访时两组患者Cobb角丢失度比较差异无显著性（P＞0.05）。A组患者手术时间、术中出血量均少于B组（P＜0.05）；两组患者住院时间、术后引流量及植骨融合率比较差异均无显著性（P＞0.05）。结论钛网植骨较单纯自体髂骨块植骨，植入更加方便，可以有效缩短手术时间、减少术中出血量，是治疗胸腰椎结核的一种安全有效的方法。Objective To investigate the clinical efifcacy of autogenous iliac bone graft alone and iliac bone graft associated with titanium mesh on thoracolumbar spinal tuberculosis treatment. Method Retrospective analysed of 67 cases of patients with thoracolumbar spinal tuberculosis that were treated by thorough focal debridement and internal ifxation of bone graft for fusion from February 2007 to January 2013 in our hospital were proceeded. There were 31 cases of patients treated with internal fixation of simple autogenous iliac bone graft for fusion （group A）, and 36 cases of patients treated with internal fixation of iliac bone graft associated with titanium mesh for fusion （group B）. The following indexes of the two groups before and after surgery were compared, they were：grading according to American Spinal Injury Association （ASIA）, Cobb angle and the loss of it at the last follow-up, fusion rate of bone graft, operative time, transoperative bleeding volume, hospitalization time and postoperative drainage volume. Result The time of follow-up was 22 to 53 months, the average of which was 39.5 months. The postoperative neurological function in the two groups had improved, but with no signiifcant difference （P〉0.05）. Cobb angle signiifcantly decreased after surgery （P 0.05）. The operative time and transoperative bleeding volume in group A was less than that in group B （P 0.05）. Conclusion Bone graft with titanium mesh is more facile for grafting compared with autogenous iliac bone graft alone. It could effectively＆nbsp;shorten operative time and decrease transoperative bleeding volume. It is a safe and efficient approach of treating thoracolumbar spinal tuberculosis.

关 键 词：胸 腰椎结核 自体髂骨块 钛网 植骨融合内固定术 

分 类 号：R687.3[医药卫生—骨科学]