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Ⅰ期后路病灶清除植骨融合内固定治疗胸椎结核
Hits: 2502   Download times: 1528   Received:March 19, 2013    
作者Author单位UnitE-Mail
丁少成 DING Shao-cheng 六安市第二人民医院骨科, 安徽 六安 237008 Department of Orthopaedics, the Second People's Hospital of Liu'an City, Liu'an 237008, Anhui, China 1366281200@139.com 
曹家俊 CAO Jia-jun 六安市第二人民医院骨科, 安徽 六安 237008 Department of Orthopaedics, the Second People's Hospital of Liu'an City, Liu'an 237008, Anhui, China  
魏学忠 WEI Xue-zhong 六安市第二人民医院骨科, 安徽 六安 237008 Department of Orthopaedics, the Second People's Hospital of Liu'an City, Liu'an 237008, Anhui, China  
周本学 ZHOU Ben-xue 六安市第二人民医院骨科, 安徽 六安 237008 Department of Orthopaedics, the Second People's Hospital of Liu'an City, Liu'an 237008, Anhui, China  
王凤民 WANG Feng-min 六安市第二人民医院骨科, 安徽 六安 237008 Department of Orthopaedics, the Second People's Hospital of Liu'an City, Liu'an 237008, Anhui, China  
期刊信息:《中国骨伤》2013年26卷,第7期,第543-545页
DOI:10.3969/j.issn.1003-0034.2013.07.003


目的: 探讨Ⅰ期单纯后路病灶清除、椎弓根螺钉固定、植骨融合治疗胸椎结核的疗效及适应证。

方法: 2005年1月至2011年5月对12例胸椎结核患者行术前、术后常规抗痨治疗,Ⅰ期行单纯后路病灶清除植骨椎弓根螺钉内固定,其中男7例,女5例;平均年龄45岁,平均病程15个月。观察手术时间、出血量,术后植骨融合、局部后凸畸形矫正、神经功能恢复情况。

结果: 所有患者病灶清除彻底,植骨融合良好。手术时间120~210 min,平均170 min;术中出血量200~1 000 ml,平均510 ml.后凸Cobb角术前平均(28.7±9.2)°,术后平均(8.2±3.5)°,差异具有统计学意义(P<0.05).术后末次随访无内固定并发症,无后凸矫正丢失,无结核复发。神经功能Frankel分级均恢复为E级。

结论: 单纯Ⅰ期后路病灶清除并植骨融合、椎弓根螺钉固定治疗胸椎结核具有病灶清除彻底、手术时间短、出血量少、后凸畸形矫正明显、融合率高等优点
[关键词]:结核,脊柱  病灶清除  外科手术
 
Surgical treatment of thoracic tuberculosis with one stage posterior debridement and bone grafting fusion and internal fixation
Abstract:

Objective: To investigate the effect and indication of one stage posterior debridement and bone grafting fusion and internal fixation for thoracic tuberculosis.

Methods: From January 2005 to May 2011,12 patients with thoracic tuberculosis were treated with one stage posterior debridement and pedicle screw fixation combined with regular anti-tuberculosis treatment before and after operation. There were 7 males and 5 females,with an average age of 45 years and average course of 15 months. Information of operative time,blood loss,bony fusion,local kyphosis and neurologic functional were evaluated.

Results: All infective focus were thoroughly removed and bone graft obtained fusion. The mean of operative time and blood loss were 170 min (120-210 min) and 510 ml (200-1 000 ml),respectively. Cobb angle from (28.7±9.2)° preoperatively decreased to (8.2±3.5)° postoperatively(P<0.05). No kyphosis correction loss,tubercular recurrence or failure of internal fixation was found. According to Frankel grade to evaluate neurological function,all patients arrived to grade E.

Conclusion: One stage posterior debridement and bone grafting fusion and internal fixation is an effective method in treating thoracic tuberculosis. It has advantages such as thorough debridement,short operative time,less blood loss,more kyphosis correction and higher bony fusion rate.
KEYWORDS:Tuberculosis,spinal  Debridement  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:丁少成,曹家俊,魏学忠,周本学,王凤民.Ⅰ期后路病灶清除植骨融合内固定治疗胸椎结核[J].中国骨伤,2013,26(7):543~545
英文格式:DING Shao-cheng,CAO Jia-jun,WEI Xue-zhong,ZHOU Ben-xue,WANG Feng-min.Surgical treatment of thoracic tuberculosis with one stage posterior debridement and bone grafting fusion and internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(7):543~545
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