脊柱内固定对脊柱结核治疗的影响

目的 分析脊柱内固定对脊柱结核疗效的影响.方法 回顾性分析2004年6月至2010年6月手术治疗的脊柱结核患者65例.所有患者均在化疗的基础上行手术治疗,采用单纯病灶清除10例,病灶清除加植骨16例,病灶清除植骨加内固定39例.结果 65例中失访3例,其余患者平均随访2.7年.所有患者切口甲级愈合,术后胸腰背痛均消失、活动障碍均获得明显改善.未行内固定的患者,脊柱融合率为57.6%(15/26),平均融合时间为6.8个月;行内固定的患者,脊柱融合率为95.0%(37/39),平均融合时间为3.2个月.患者的神经功能均获得明显恢复,术后Frankel分级为:B级5例,C级5例,D级20例,E级32例.主要并发症包括血气胸3例,脑脊液漏2例,内固定断裂、脱出1例,术后复发1例,股神经激惹征4例.予相应治疗后均治愈.结论 脊柱内固定可重建脊柱稳定性,促进植骨融合,缩短融合时间,提高手术疗效.

Abstract：

Objective To analyze the influence of the internal fixation in the treatment of spinal tuberculosis. Methods Sixty-five spinal tuberculosis patients treated by surgery were retrospectively analyzed. All patients got surgery at the base of chemotherapy. Ten cases got simple focal cleaning. Sixteen cases got focal cleaning and bone crafting. Thirty-nine cases got focal cleaning with bone grafting and internal fixation. The therapeutic effects of those patients were observed. Results Sixty-two cases were followed-up for an average of 2.7 years. The bone fusion rate was 57.6% (15/26) in patients without internal fixation and the fusion time was 6.8 months. The bone fusion rate was 95.0% (37/39) in patients with internal fixation and the fusion time was 3.2 months. Patients' nerve function was obviously recovered. According to post-operation Frankel Grading, there were 5 cases in level B, 5 cases in C, 20 cases in D, and 32 cases in E. Main complications included 3 case of hemopenumothorax, 2 case of cephalospinal fluid leakage, 1 case of fracture of internal fixation, 1 case of recurrence and 4 cases of femoral nerve irritation. Those patients were cured. Conclusion Internal fixation can reconstruct the spinal stability, promote the bone fusion rate, cut down the fusion time and improve the surgical effect.

Internal fixation in the treatment of spinal tuberculosis

Objective To analyze the influence of the internal fixation in the treatment of spinal tuberculosis. Methods Sixty-five spinal tuberculosis patients treated by surgery were retrospectively analyzed. All patients got surgery at the base of chemotherapy. Ten cases got simple focal cleaning. Sixteen cases got focal cleaning and bone crafting. Thirty-nine cases got focal cleaning with bone grafting and internal fixation. The therapeutic effects of those patients were observed. Results Sixty-two cases were followed-up for an average of 2.7 years. The bone fusion rate was 57.6% (15/26) in patients without internal fixation and the fusion time was 6.8 months. The bone fusion rate was 95.0% (37/39) in patients with internal fixation and the fusion time was 3.2 months. Patients' nerve function was obviously recovered. According to post-operation Frankel Grading, there were 5 cases in level B, 5 cases in C, 20 cases in D, and 32 cases in E. Main complications included 3 case of hemopenumothorax, 2 case of cephalospinal fluid leakage, 1 case of fracture of internal fixation, 1 case of recurrence and 4 cases of femoral nerve irritation. Those patients were cured. Conclusion Internal fixation can reconstruct the spinal stability, promote the bone fusion rate, cut down the fusion time and improve the surgical effect.