病灶清除植骨内固定治疗胸腰椎结核

目的评价采用病灶清除植骨内固定术治疗胸腰椎结核的疗效。方法采用前路或前后路联合病灶清除植骨内固定术治疗16例胸腰椎结核患者,术后抗结核药物治疗9~12个月。结果患者均获得随访,时间6~48个月。9例术前神经功能障碍者术后均获得明显改善:改善至C级1例,D级1例,恢复至E级7例,无神经功能障碍加重者。除1例植骨融合延期外,其余患者植骨均愈合良好。Cobb角术前22.6°~48.5°,术后10°~21°。结论胸腰椎结核采用病灶清除植骨融合及内固定术,彻底清除病变组织,可重建脊柱稳定性,提高脊柱结核的治愈率。

The effect of radical debridement with bone grafting and internal fixation for treatment of thoracic and lumbar tuberculosis

Objective To evaluate the clinical efficacy of radical debridement with bone grafting and internal fixation for treatment of thoracic and lumbar tuberculosis. Methods Sixteen patients of thoracic and lumbar tuberculosis were undergone surgical treatment and anti-tuberculosis drugs chemotherapy for 9 ~12 months after surgical treat-ment. Results The period of follow-up lasted from 6 months to 48 months, 9 patients had relief on nerve function evidently:one patient had improved to grade C, one patient with grade D, and 7 patients recovered to grade E from upper grade,no case with aggravation of neurological dysfunction after operation was found. All of the bone graft a-chieved solid fusion except one case. The preoperative kyphotic angle was restored from 22. 6°~48. 5° to 10°~21° after operation. Conclusions The treatment of thoracic and lumbar tuberculosis by using radical debridement with bone grafting and internal fixation can reconstruct the stability of spine and improve the rate of treating spine tubercu-losis.