摘要
目的 观察病灶切除植骨、经椎弓根内固定术治疗脊柱结核的临床疗效。方法 1 996年 1 0月至 1 998年 1 1月 ,我院有 34例胸腰椎结核患者接受椎弓根器械固定、一期或二期病灶切除植骨手术 ,术后随访 3~ 5年。结果 患者术后 1周左右腰背部疼痛和结核中毒症状缓解 ,术后约 4~ 6周时红细胞沉降率恢复正常 ,术后 4~ 6个月椎间植骨全部融合 ,脊柱结核全部治愈。有 1 2例患者术前脊柱后凸角度平均 2 4度 (1 0~ 32度 ) ,术后平均 9度 (5~ 1 3度 )。有 9例患者术前合并脊髓功能损害 (Frankel分级为C~D级 ) ,术后 1年内脊髓功能恢复正常。结论 病灶切除植骨经椎弓根内固定治疗脊柱结核 ,术后能立即恢复脊柱稳定性 ,免除了患者长期卧床之苦。此外 。
Objective To evaluate the surgical outcomes of spinal tuberculosis treated with transpedicular instrumentation and interbody auto grafting.Methods Thirty four patients of thoracolumbar tuberculosis were treated with transpedicular instrumentation,radical focus resection and interbody auto grafting,combined with 6 or 9 month antituberculous medication from October 1996 to November 1998.All patients were followed up prospectively for 3 to 5 years postoperatively.Results The back pain and tuberculous symptoms were relieved about one week postoperatively.The erythrocyte sedimentation rate came back to normal level from 4 to 6 weeks postoperatively.The solid interbody arthodesis was achieved from 4 to 6 months postoperatively.All patients were cured of tuberculous lesions in spinal column or in other region,and there were no tuberculous recurrence.In 12 patients,average preoperative kyphosis angle was 24°(range 10°~32°),and that was 9°(range 5°~13°) immediately after surgery.The average correction of kyphotic deformity was 15° and was maintained unchanged in follow up period postoperatively.Nine patients who had type C or type D neurological lesions,according to Frankel gradation,had complete recovery one year postoperatively.Conclusion In spinal tuberculous operation,transpedicular instrumentation and interbody fusion are essential in providing rigid stabilization of spinal column,correcting or preventing kyphotic deformity,accelerating focus healing up and shortening chemotherapy period.Transpedicular instrumentation is necessary in short segments fixation and preserving functional unit of spine.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2002年第16期1121-1123,共3页
National Medical Journal of China