| 后路椎弓根螺钉内固定联合前路病灶清除植骨融合治疗胸腰段脊柱结核 |
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Received:April 08, 2009
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| 作者 | Author | 单位 | Unit | E-Mail |
| 徐跃根 |
XU Yue-gen |
嘉兴市第一医院骨科,浙江 嘉兴 314000 |
Department of Orthopaedics,the First Hospital of Jiaxing,Jiaxing 314000,Zhejiang,China |
succeedoog@163.com |
| 杨亚东 |
YANG Ya-dong |
嘉兴市第一医院骨科,浙江 嘉兴 314001 |
Department of Orthopaedics,the First Hospital of Jiaxing,Jiaxing 314001,Zhejiang,China |
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| 刘师良 |
LIU Shi-liang |
嘉兴市第一医院骨科,浙江 嘉兴 314002 |
Department of Orthopaedics,the First Hospital of Jiaxing,Jiaxing 314002,Zhejiang,China |
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| 期刊信息：《中国骨伤》2009年22卷，第12期，第938-940页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨一期前路病灶清除、自体骨椎间植骨融合、后路椎弓根螺钉固定治疗胸腰椎结核的临床疗效。
方法：2002年2月至2007年3月，共收治脊柱结核患者21例，其中男13例，女8例；平均年龄45.3岁。病变部位为胸腰段，2个椎体3例，3个椎体17例，4个椎体1例，皆有后凸畸形，平均Cobb角(28.0±9.7)°。术前Frankel脊髓功能分级：B级3例，C级5例，D级1例，E级12例。术前应用异烟肼、利福平、乙胺丁醇、吡嗪酰胺抗痨及全身支持治疗，手术采用后路椎弓根钉棒固定、前路病灶清除、前后路植骨融合术，术后继续化疗9～12个月。术后随访，观察脊髓功能改善情况，根据术前、术后X线片分析植骨融合情况及脊柱Cobb角并进行统计学分析。
结果：切口均Ⅰ期愈合，随访1～6年，平均2.5年，末次随访时平均Cobb角(9.8±3.3)°，平均矫正17.2°，术前、术后比较，P<0.01,植骨均融合。Frankel脊髓功能分级：C级1例，D级3例，E级17例。
结论：胸腰段脊柱结核经后路椎弓根螺钉内固定、前路病灶清除、植骨融合，可有效纠正脊柱后凸畸形，重建脊柱稳定性，获得良好的骨性愈合。 |
| [关键词]:胸椎 腰椎 结核,脊柱 内固定器 骨移植 |
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| Effect of surgical treatment for thoracolumbar spinal tuberculosis by anterior radical debridement with bone graft fusion and posterior pedicle screw-rods system fixation |
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Abstract:
Objective: To study the clinical effects of one stage surgical treatment of thoracolumbar spinal tuberculosis by anterior radical debridement with bone graft fusion and posterior pedicle screw-rods system fixation.
Methods: From February 2002 to March 2007,21 patients who were 45.3 years old on average with thoracolumbar spinal tuberculosis,including 13 males and 8 females were underwent surgical treatment of posterior pedicle screw-rods system fixation,correction of deformities,anterior radical debridement,bone graft fusion. Among them,3 patients had 2 involved vertebras,17 patients had 3 involved vertebras,and 1 patient had 4 involved vertebras. The patients were all complicated with kyphosis deformity with an average Cobb angle of(28.0±9.7)°。 According to the Frankel neurological function grade system,3 cases in grade B,5 in grade C,1 in grade D,12 in grade E. All the patients received antiphthisic treatment with isonicotinylhydrazide(INH),rifampicin(RFP),Ethambutol(EMB),pyrazinamide(PZA),and support therapy in preoperation. The chemotherapy was continued 9 to 12 months after operation. Neurological functions of all cases were investigated,and radiography was analyzed pre-operation and post-operation to determine the state of bony fusion and the correction of spinal kyphosis. Statistical analysis was made according to the preoperative and post-operative Cobb angle.
Results: The follow-up period ranged from 1 to 6 years with 2.5 years on average. All the patients had primary healing of the incisions. The Cobb angle was(9.8±3.3)°in post-operation. The kyphosis deformity was corrected 17.2° in thoracolumbar on average(t=-13.48,P<0.01). According to the Frankel neurological functional grade system,1 case was in grade C,3 in grade D,and 17 in grade E.
Conclusion: It is effective for patients with thoracolumbar spinal tuberculosis in correction of spinal kyphosis,reconstruction of the spinal stability and bony fusion by anterior radical debridement with bone graft fusion and posterior pedicle screw-rods system fixation. |
| KEYWORDS:Thoracic vertebrae Lumbar vertebrae Tuberculosis,spinal Internal fixators Bone transplantation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐跃根,杨亚东,刘师良.后路椎弓根螺钉内固定联合前路病灶清除植骨融合治疗胸腰段脊柱结核[J].中国骨伤,2009,22(12):938~940 |
| 英文格式: | XU Yue-gen,YANG Ya-dong,LIU Shi-liang.Effect of surgical treatment for thoracolumbar spinal tuberculosis by anterior radical debridement with bone graft fusion and posterior pedicle screw-rods system fixation[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(12):938~940 |
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