摘要
目的:探讨一期前路病灶清除植骨和后路小切口椎弓根钉内固定治疗胸腰椎结核的应用效果。方法:47例胸腰椎结核患者,术前采用四联正规抗结核治疗2～4周,所有患者采用后路椎弓根螺钉系统矫形内固定,同期行前路病灶清除植骨术,术后继续抗结核治疗。结果:平均随访16个月,患者骨折均达到骨性愈合标准,腰背疼痛及神经症状均明显缓解,术后Cobb角与术前相比明显减少(P<0.01),随访1年,Cobb角与术后比,差异无统计学意义(P>0.05)。术后1年时Frankel分级明显改善:5例B级恢复至C级2例、D级3例,6例C级恢复至D级3例、E级3例,11例D级恢复至E级。结论 :一期前路病灶清除植骨和后路小切口椎弓根钉内固定术是一种安全、有效的胸腰椎结核治疗方法。
Objective： To investigate the clinical effects of one-stage anterior focus clearance and bone graft and posterior small incision approach pedicle internal fixation for treatment of the thoracolumbar tuberculosis.Methods：A total of 47 thoracolumbar tuberculosis patients were treated with pre-operativel routine antituberculous medication for 2-4 weeks,then they all underwent one-stage anterior focus clearance and bone graft and posterior approach pedicle internal fixation,antituberculous medication continued after operation.Results：All patients were followed up with an average 16 months.Bony fusion was obtained in all patients.Obvious improvement in back pain and neurological deficits were shown in most patients.The average kyphosis Cobb′s angle was significantly smaller after the operation than before and there was no significantly difference after one year follow up than after the operation.The Frankel classification was significantly improved as 5 grad B cases were evaluated as grade C（2 cases） and grade D（3 cases）,6 grade C cases were evaluated as grade D（3 cases） and grad E（3 cases）,11 grade D cases were evaluated as grade E.Conclusions：One-stage anterior focus clearance and bone graft and posterior small incision approach pedicle internal fixation is a safe and effective method for treating the thoracolumbar tuberculosis.
出处
《海南医学院学报》
CAS
2012年第2期207-209,213,共4页
Journal of Hainan Medical University
基金
中国高校医学期刊临床专项资金项目(11221014)~~
关键词
胸腰椎结核
病灶清除
椎弓根钉
内固定
Tuberculosis of thoracolumbar spine
Debridement
Pedicle screw
Internal fixation
