前路病灶清除植骨内固定与后路内固定治疗多节段胸腰椎椎体结核的疗效对比分析  

The clinical curative effect of anterior radical debridement with iliac grafting and internal fixation or posterior internal fixation in the treatment of multi-leve thoracolumbar spinal tuberculosis

作　　者：汪卫[1] 周永强[1] 王勇平[1] 

机构地区：[1]内江市第一人民医院骨科,四川内江641000

出　　处：《生物骨科材料与临床研究》2016年第3期38-41,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨前路病灶清除植骨前路内固定与后路内固定治疗多节段胸腰椎体结核的疗效的差异。方法 2011年-2014年间采用前路病灶清除植骨内固定与后路内固定治疗多节段胸腰椎体结核总共70例。其中前路内固定组32例,后路内固定组38例。观察两组患者手术时间,术中出血,并发症发生情况,住院天数和术后脊柱后突畸形纠正角度,植骨融合等情况。结果经平均2年的随访证实,前路固定组手术时间、术中出血量、住院天数、短于后路内固定组;术后并发症发生率相当,两组患者内固定植骨融合速度相当;前路组和后路固定组术后畸形矫正角度分别为13.1°,24.5°,有显著性差异（P〈P〈0.05）。结论脊柱结核前路内固定可以缩短病人手术时间,术中出血量,住院天数,两组患者的植骨融合速度和并发症发生相当,但后路手术对多椎体结核中后突畸形的矫正具有重要意义。Objective To observation the clinical effect of anterior radical debridement with iliac grafting and internal fixation or posterior internal fixation in the treatment of multi-leve thoracolumbar spinal tuberculosis. Methods In this study, we retrospective review seventy patients with multi-leve thoracolumbar spinal tuberculosis. Thirty-two patients were treated with anterior radical debridement with iliac grafting and internal fixation, the others were treated with anterior radical debridement with iliac grafting and posterior internal fixation. To value relevant index of the two groups during twenty-four moths＇ follow up. Results The anterior internal fixation can short the operative time, hospital stay and the blood loss.The correction angle of anterior and posterior was respectively 13.1,24.5, with a statistical significance（ P〈0.05）.But it with a similar rate of complications. Conclusion The anterior internal fixation can short the operative time, hospital stay and the blood loss. But they achieve with a similar rate of complications. The posterior in fixation have a favourable effect in the correction of scoliosis.

关 键 词：椎体结核 内固定术 病灶清除术 

分 类 号：R687.3[医药卫生—骨科学]