一期前路椎体间植骨并内固定治疗胸腰椎结核

目的　探讨脊柱结核外科治疗中一期重建脊柱稳定性的重要性及内固定器械植入的安全性。　方法　总结 1997年 10月至 1999年 1月期间收治 11例胸腰椎结核患者 ,采用一期前路病灶清除、椎体间自体植骨并胸腰椎“Z”形前路钛钢板内固定治疗。　结果　经平均 16个月的随访 ,11例患者脊柱结核均治愈 ,无局部结核复发 ,植骨全部骨性融合 ,融合时间平均为 3.8个月 ,后凸矫正角度 18° ,无手术并发症。　结论　早期重建脊柱稳定性在脊柱结核外科治疗中具有重要的意义 ,在结核病灶局部植入钛质内固定器械是安全和有效的。

Anterior interbody autografting and internal fixation for primary surgical management of thoracolumbar spinal tuberculosis

OBJECTIVES: To verify the importance of early reconstruction of spinal stability and to evaluate the safety of anterior instrumentation in surgical management of spinal tuberculosis. METHODS: Eleven cases of thoracolumbar spinal tuberculosis were treated with primary anterior debridement, interbody autografting and Z-plate fixation from October 1997 to January 1999. RESULTS: All the 11 cases healed without any recurrence after follow-up for an average of 16 months. Spinal fusion occurred in 3.8 months on average after surgery. 18 degrees of kyphosis correction was achieved with no associated complication. CONCLUSIONS: Early reconstruction of spinal stability plays an important role in surgical management of spinal tuberculosis, and it is safe to implant anterior titanium spinal instrument in tuberculosis foci.