前路内固定技术治疗胸腰段椎体结核和肿瘤  

TREATMENT OF THE TUBERCULOSIS AND TUMOR OF THORACOLUMBAR SEGMENT WITH THE ANTERIOR INTERNAL FIXATION TECHNIQUESS

作　　者：张宏其[1] 李康华[1] 龙文荣[1] 周江南[1] 廖前德[1] 邓展生[1] 龚家琳[1] 

机构地区：[1]中南大学湘雅医院骨科,长沙410008

出　　处：《中国现代医学杂志》2002年第19期58-61,共4页China Journal of Modern Medicine

摘　　要：目的 :探讨Z - plate-ⅡTM 和TSRH前路内固定技术在胸腰段椎体结核和肿瘤手术中的可行性和价值。方法 :2 7例胸腰段椎体结核和肿瘤病人 ,结核 19例 ,肿瘤 8例 ;经肋横突切口或剖腰切口进入 ,达病椎前外侧 ,病灶清除后植骨 ;17例采用植骨、Z -plate -ⅡTM固定 ,10例采用TSRH内固定。结果 :2 7例随访 4～ 2 4个月 ,平均 18.6个月 ,术后照片侧弯和后凸畸形分别平均矫正 80 %和 76 % ,植骨在术后 3～ 6个月内、平均 4个月时融合 ;有神经症状者在术后半年Frankel分级平均提高 1.4 4级。结论 :在胸腰段椎体结核和肿瘤的前路病灶清除、减压、植骨手术中 ,采用Z - plate-ⅡTM、TSRH内固定 ,是确实可行、有效的。Objective:To explore the feasibility and value of the treatment of tuberculosis and tumor of thoracolumbar segment with the Z-plate-Ⅱ TM and TSRH anterior internal fixation techniques.Method: Twenty-seven cases of tuberculosis and tumor of Thoraco-lumbar segment (tuberculosis: 19 cases, tumor:8 cases) were operated through posterolateral costotransversectomy or kidney incision. Seventeen cases were fixed with Z-plate-Ⅱ TM and implanted autologous iliac, rib grafts after the pathologic tissue being resected and cleared. Ten cases were fixed with TSRH (Texas Scottish Rite Hospital).Result:Twenty-seven cases were followed-up 4-24months post-OP,for an average 18.6months. The X-ray photos of post-OP showed that the average scoliosis correction was 80%, the average kyphosis correction was 76%, all the bone grafts were fused within 3～6monthes (average 4 monthes), the average Frankel grade were raised 1.44 grade for the cases which accompanied neurotic symptom at the 6monthes post-OP.Conclusion:For the tuberculosis and tumor of throacolumbar segment, Z-plate-Ⅱ TM and TSRH fixation techniques were feasibility and effection after the lesion vertebra obtained anterior clearing,decompression and bone grafting.

关 键 词：椎体肿瘤 前路内固定技术 治疗 胸腰段 椎体结核 

分 类 号：R529.2[医药卫生—内科学] R738.1[医药卫生—临床医学]