脊柱结核的手术治疗与临床分析  

Surgical treatment and clinical study of spinal tuberculosis

作　　者：周雪峰[1] 海涌[1] 马华松[1] 邹德威[1] 陈晓明[1] 王晓平[1] 鲍磊[1] 

机构地区：[1]中国人民解放军脊柱外科中心,第306医院骨科北京100101

出　　处：《临床骨科杂志》2003年第4期335-337,共3页Journal of Clinical Orthopaedics

摘　　要：目的　探讨脊柱结核的手术治疗。方法　 10例脊柱结核患者行手术治疗 ,4例行病灶前路清除植骨融合术 ,6例行病灶清除植骨融合钢板内固定术。 10例均用三联抗痨治疗至术后 9～ 12个月。结果　患者伤口均一期愈合 ,无窦道及伤口不愈 ,随访 2年后Frankel评分为D级 2例 ,E级 8例。后期脊柱后凸畸形 2例。结论　及时正确的手术干预及规范化的抗痨治疗是提高脊柱结核治疗效果的关键。彻底的病灶清除植骨融合术并一期内固定术可以有效防止后凸畸形的发生。Objective To investigate surgical treatment of spinal tuberculosis. Methods 10 cases with spinal tuberculosis were treated by surgery, of which 4 patients were performed anterior debridement and bone grafting, and 6 patients were performed debridement, one stage internal fixation and bone grafting. All patients were treated by regular chemotherapy for 9～12 months. Results All the patients got primary healing without sinus formation or wound unhealing. No recurrence of spinal tuberculosis was found during the 2 years' following up. According to Frankel scoring system, the recovery reached grade D in 2 cases, and E in 8 cases. Late Kyphosis complicated in 2 cases. Conclusion The key points of the treatment for spinal tuberculosis are right surgical treatment and regular chemotherapy. Complete debridment with bone grafting and internal fixation in one stage is effective to prevent late kyphosis.

关 键 词：脊柱结核 脊椎后凸 骨折固定术 内 脊柱融合术 

分 类 号：R529.2[医药卫生—内科学] R687.34[医药卫生—临床医学]