| 前路Ⅰ期病灶清除加植骨融合内固定治疗腰骶段结核 |
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Received:November 23, 2012
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| 作者 | Author | 单位 | Unit | E-Mail |
| 杨斌辉 |
YANG Bin-hui |
西安交通大学医学院附属3201医院骨科, 陕西 汉中 723000 |
No. 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong 723000, Shaanxi, China |
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| 欧阳振 |
OUYANG Zhen |
西安交通大学医学院附属3201医院骨科, 陕西 汉中 723000 |
No. 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong 723000, Shaanxi, China |
aier_007@sina.com |
| 赵金龙 |
ZHAO Jin-long |
西安交通大学医学院附属3201医院骨科, 陕西 汉中 723000 |
No. 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong 723000, Shaanxi, China |
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| 张波 |
ZHANG Bo |
西安交通大学医学院附属3201医院骨科, 陕西 汉中 723000 |
No. 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong 723000, Shaanxi, China |
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| 期刊信息：《中国骨伤》2013年26卷，第7期，第546-548页 |
| DOI：10.3969/j.issn.1003-0034.2013.07.004 |
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目的: 探讨经前路腹膜外途径Ⅰ期病灶清除、植骨融合、单钉棒内固定治疗腰骶段结核的临床效果。
方法: 2005年3月至2011年2月采用经前路腹膜外途径,彻底清除病灶,大块髂骨支撑植骨,单钉棒椎体侧前方内固定治疗腰骶段(L3-S1)结核18例,男13例,女5例;年龄24～61岁,平均38.5岁;病程3～14个月,平均5.5个月。病变节段:L3,4 2例,L4,5 5例,L4 2例,L5S1 6例,L4-S1 3例。术后常规抗结核治疗12～18个月,定期复查血沉及CT、X线片,监测抗结核治疗效果及植骨融合情况。
结果: 术中显露充分,病灶清除彻底,无大血管、神经、输尿管损伤等严重并发症发生。随访6～42个月,平均13个月。内固定无松动、断裂;植骨块无移位,植骨融合良好;血沉、C-反应蛋白正常,结核病变无复发。
结论: 经前路腹膜外途径行病灶清除、植骨融合、单钉棒内固定治疗腰骶段结核,能Ⅰ期完成病变的切除和腰骶椎的重建,在此区域单钉棒内固定是可行的。 |
| [关键词]:腰骶部 结核,脊柱 骨移植 内固定器 |
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| One stage anterior debridement,bone fusion and internal fixation for the treatment of lumbosacral tuberculosis |
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Abstract:
Objective: To explore the clinical effect of the anterior debridement,bone fusion,single screw-rod fixation for the treatment of lumbosacral tuberculosis.
Methods: From March 2005 to February 2011,18 patients with lumbosacral (L3-S1) tuberculosis (including 13 males and 5 females with an average age of 38.5 years old ranging from 24 to 61 years) were treated with removing focus completely,large piece of iliac bone strut grafting,single screw-rod vertebral lateral anterior internal fixation through anterior extraperitoneal approach. The process segment was L3,4 in 2 cases,L4,5 in 5,L4 in 2,L5S1 in 6,L4-S1 in 3. All patients were routinely treated with antituberculous druy for 12-18 months after operation,erythrocyte sedimentation rate and liver function,X-ray films,CT examination,were statedly rechecked,and condition of antituberculosis treatment and bone grafting fusion were detected.
Results: Intraoperative focus were exposed clearly,debrided thoroughly. There were no large blood vessels,nerves,ureteral injury and other serious complications during operation. All patients were followed up form 6 to 42 months with an average of 13 months. Internal fixations were not loosening,breaking;bone of grafting was not displacementand obtained good healing;erythrocyte sedimentation rate and C-reactive protein were normal;tuberculosis lesions were not recurrence.
Conclusion: Through anterior extraperitoneal approach to remove focus,bone fusion,single screw-rod fixation in treating lumbosacral tuberculosis can complete cut lesion and rebuild the stability of lumbosacral vertebrae,in this area with a single screw and rod fixation is a feasible method. |
| KEYWORDS:Lumbosacral region Tuberculosis,spinal Bone transplantation Internal fixators |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 杨斌辉,欧阳振,赵金龙,张波.前路Ⅰ期病灶清除加植骨融合内固定治疗腰骶段结核[J].中国骨伤,2013,26(7):546~548 |
| 英文格式: | YANG Bin-hui,OUYANG Zhen,ZHAO Jin-long,ZHANG Bo.One stage anterior debridement,bone fusion and internal fixation for the treatment of lumbosacral tuberculosis[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(7):546~548 |
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