病灶清除、植骨融合内固定术治疗腰骶段脊柱结核54例  

One-stage posterior radical eradication and bone graft fusion in treating lumbosacral tuberculosis

作　　者：张超[1] 路坦[1] 

机构地区：[1]新乡医学院第一附属医院骨外科,新乡453100

出　　处：《陕西医学杂志》2016年第1期74-76,共3页Shaanxi Medical Journal

基　　金：河南省医学科技攻关计划项目(201304029);河南省新乡市科技发展计划项目(14SF21)

摘　　要：目的：探讨一期后路病灶清除、植骨融合内固定术治疗腰骶段脊柱结核的临床疗效。方法：选取我院腰骶段脊柱结核患者54例,所有患者均采用一期后路病灶清除、植骨融合内固定术手术治疗,术前术后给予规范的抗结核治疗,观察患者术前,术后及随访时腰骶角、椎间隙高度等情况。结果：所有患者手术时间为160~290min,平均220.5±45.6min,出血150~1000ml,平均517.4±69.8ml,随访时间为6~36个月,平均25.6±5.2个月。切口均一期愈合,无慢性窦道形成,随访期间1例患者术后6月复发,经手术治疗后痊愈。5例患者术后出现神经根性刺激症状,对症治疗后好转。术后,末次随访中腰骶角较术前均有有明显的提高（P〈0.05）,椎间隙高度改变在术前,术后及末次随访结果具有显著性差异（P〈0.05）。结论：一期后路病灶清除、植骨融合内固定术可有效治疗腰骶段脊柱结核,恢复腰骶角正常生理曲度,增加椎间隙高度,明显改善患者腰痛等症状。Objective： To investigate the clinical effect of treatment of lumbosacral tuberculosis. Meth- ods： Selected 54 lumbosacral tuberculosis patients in our hospital from January 2012 to January 2014, all patients were treated with one stage posterior focus debridement, bone graft fusion and internal fixation surgery. The patients were observed before and after operation and follow-up of lumbosacral angle and intervertebral space height. Results： All patients with operation time for 160-290min, average（220.54-45.6）min, bleeding 150-1000ml （517.4 ±69.8） ml, follow-up time ranged from 6 to 36 months, with an average（25.6 ± 5.2） months. The incisionhealed, without chronic sinus formation during the follow-up period, 1 cases of patients with postoperative recurrence after operation recovered by June. 5 cases of patients with nerve root irritation symptoms, symptomatic treatment improved. After the operation, at the time of the last follow-up lumbosacral angle was preoperative had significantly improved, the difference had statistical significance （P〈0.05）, intervertebral space height change in the preoperative, postoperative namely at the last follow-up, the difference had statistical significance （P〈0.05）. Conclusion： One-stage posterior radical eradication and bone graft fusion in treating lumbosacral tuberculosis can be effective, recover lumhosacral normal physiological curvature, increase the height of intervertebral spaces, significant improvement in patients with low back pain and symptoms.

关 键 词：结核 脊柱/外科学 骨折固定术 内 @植骨融合内固定术 @一期后路病灶清除 

分 类 号：R529.2[医药卫生—内科学]