前路病椎切除植骨内固定治疗脊柱结核

目的　探讨经脊柱前路结核病灶清除的同时植骨内固定的可行性和必要性 ,以及对脊柱结核的治疗效果。方法　 1998年 2月～ 2 0 0 0年 8月采用脊柱前路病椎切除加植骨 ,并采用Orion或Z plate钢板进行椎体固定。共治疗 12例脊柱结核 ,观察植骨融合及矫正畸形情况和结核病灶愈合情况。结果　经平均 10个月的随访 ,12例患者脊柱结核均治愈 ,植骨与受骨区全部骨性融合 ,融合时间平均为 5 8个月 ,后凸矫正角度平均 16°。全组病例切口均一期愈合。无手术并发症。结论　本方法可经脊柱前路作较彻底的病灶清除 ,并较好地进行脊柱矫形和椎管减压 ,完成脊柱稳定性重建 ,有利于患者早期离床活动和脊柱结核治愈率的提高。

Anterior vertebrectomy and plating for spinal tuberculo sis

OBJECTIVE: To study the effect of anterior vertebrectomy, bone grafting and plating in the treatment of spinal tuberculosis. METHODS: Between February 1998 and August 2000, 12 patients with spinal tuberculosis were operated with anterior vertebrectomy, bone grafting and plating. Evaluation including bone fusion rate, correction of deformity and status of spinal lesion was carried out. RESULTS: In an average of ten months, spinal tuberculosis was completely cured and solid bone fusion had taken place in all 12 patients. The time for bone fusion averaged 5.8 months and the average angle of correction of kyphosis was 16 degrees. CONCLUSIONS: Anterior plating following vertebrectomy and bone grafting offers a complete removal of lesion and decompression of the spinal canal as well as reconstruction of spinal stability. Early rehabilitation and an increased curative rate can be expected through this procedure.