一期病灶切除椎管前方减压前路内固定治疗脊柱结核合并截瘫  

One stage resection of anterior decompression and anterior internal fixation in the treatment of spinal tuberculosis with paraplegia

作　　者：张少华 施宗祥 王文生 王田 马琪峰 朱德智 

机构地区：[1]内蒙古自治区第四医院骨科,呼和浩特010080

出　　处：《中国实用医刊》2016年第20期49-51,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨一期病灶切除椎管前方减压前路内固定治疗脊柱结核合并截瘫的疗效。方法43例脊柱结核伴截瘫患者采用一期病灶切除椎管前方减压前路内固定治疗，观察患者治疗前后临床症状、神经和活动功能改善情况。结果43例患者植骨融合率为100．00％，未出现移位、吸收、脱落断裂等并发症；治疗前血沉为（31．6±21．0）mm／h，治疗后降低至（7．2±6．8）mm／h，差异有统计学意义（t=14．281，P〈0．05）；患者治疗后神经功能Frankel分级较治疗前明显改善（P〈0．05）；治疗后胸椎、腰椎、胸腰椎后凸Cobb角较治疗前明显降低（P〈0．05）。结论一期病灶切除椎管前方减压前路内固定治疗脊柱结核合并截瘫疗效显著，能显著改善患者神经功能及活动功能。且无明显并发症。Objective To investigate the effect of debridement and anterior decompression and anterior internal fixation on spinal tuberculosis with paraplegia. Methods Forty-three spinal tuberculosis patients with paraplegia underwent one stage resection of anterior decompression and anterior internal fixation, the clinical symptoms, neurological and functional improvement activities were observed. Results Among the 43 patients, the fusion rate of bone graft was 100. 00%, no complications such as shift, absorption and break off occurred; erythrocyte sedimentation rate was （31.6 ±21.0）mm/h before treatment, and （7. 2 ±6. 8）mm/h after treatment, the difference was significant （t = 14. 281, P 〈0. 05）. After treatment, the Frankel grade of the nerve function was improved significantly compared with that before treatment （P 〈 0. 05 ） ; the Cobb angle of thoracic vertebrae, lumbar vertebrae and thoracic vertebrae was significantly lower than that before treatment （P 〈 0. 05）. Conclusions The curative effect of one stage resection of anterior decompression of anterior internal fixation on spinal tuberculosis with paraplegia is remarkable, it can significantly improve the neurological function and activity without significant complication.

关 键 词：病灶切除 前方减压 前路内固定 脊柱结核 截瘫 

分 类 号：R687.3[医药卫生—骨科学]