Two kinds of posterior approach for Kümmell's disease after osteoporotic thoracolumbar fracture

To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolum-bar Kummell's disease.Methods: Clinical and radiographic results of 1-seg-mental pedicle screw fixation combined with vertebroplasty (Group A, n=12) or posterior shortening osteotomy (Group B, n=16) for osteoporotic thoracolumbar Kummell's disease were analyzed retrospectively. Japanese orthopedic asso-ciation (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radio-graphic results. Complications related to operation and de-vices were also considered. Results: The follow-up period was 12-54 months (average 29 months). Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t=5.306, P<0.001). There was no sig-nificant difference between Groups A and B (t=0.618, P>0.05). The kyphosis were corrected from preoperative 33.9°(A)/37.3°(B) to postoperative 10.3°(A)/6.5°(B), and 15.3°(A)/13.7°(B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postopera-tively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions: The similar clinical results can be ob-tained by the two kinds of posterior surgical methods for osteoporotic Ktimmell's disease. Posterior spinal shorten-ing is a better choice for patients with serious kyphosis combined with neurological deficit than the other.     

Two kinds of posterior approach for Kümmell's disease after osteoporotic thoracolumbar fracture

To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolum-bar Kummell's disease.Methods: Clinical and radiographic results of 1-seg-mental pedicle screw fixation combined with vertebroplasty (Group A, n=12) or posterior shortening osteotomy (Group B, n=16) for osteoporotic thoracolumbar Kummell's disease were analyzed retrospectively. Japanese orthopedic asso-ciation (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radio-graphic results. Complications related to operation and de-vices were also considered. Results: The follow-up period was 12-54 months (average 29 months). Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t=5.306, P<0.001). There was no sig-nificant difference between Groups A and B (t=0.618, P>0.05). The kyphosis were corrected from preoperative 33.9°(A)/37.3°(B) to postoperative 10.3°(A)/6.5°(B), and 15.3°(A)/13.7°(B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postopera-tively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions: The similar clinical results can be ob-tained by the two kinds of posterior surgical methods for osteoporotic Ktimmell's disease. Posterior spinal shorten-ing is a better choice for patients with serious kyphosis combined with neurological deficit than the other.     

Two kinds of posterior approach for Kümmell's disease after osteoporotic thoracolumbar fracture

To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolum-bar Kummell's disease.Methods: Clinical and radiographic results of 1-seg-mental pedicle screw fixation combined with vertebroplasty (Group A, n=12) or posterior shortening osteotomy (Group B, n=16) for osteoporotic thoracolumbar Kummell's disease were analyzed retrospectively. Japanese orthopedic asso-ciation (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radio-graphic results. Complications related to operation and de-vices were also considered. Results: The follow-up period was 12-54 months (average 29 months). Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t=5.306, P<0.001). There was no sig-nificant difference between Groups A and B (t=0.618, P>0.05). The kyphosis were corrected from preoperative 33.9°(A)/37.3°(B) to postoperative 10.3°(A)/6.5°(B), and 15.3°(A)/13.7°(B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postopera-tively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions: The similar clinical results can be ob-tained by the two kinds of posterior surgical methods for osteoporotic Ktimmell's disease. Posterior spinal shorten-ing is a better choice for patients with serious kyphosis combined with neurological deficit than the other.     

Two kinds of posterior approach for Kümmell's disease after osteoporotic thoracolumbar fracture

To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolum-bar Kummell's disease.Methods: Clinical and radiographic results of 1-seg-mental pedicle screw fixation combined with vertebroplasty (Group A, n=12) or posterior shortening osteotomy (Group B, n=16) for osteoporotic thoracolumbar Kummell's disease were analyzed retrospectively. Japanese orthopedic asso-ciation (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radio-graphic results. Complications related to operation and de-vices were also considered. Results: The follow-up period was 12-54 months (average 29 months). Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t=5.306, P<0.001). There was no sig-nificant difference between Groups A and B (t=0.618, P>0.05). The kyphosis were corrected from preoperative 33.9°(A)/37.3°(B) to postoperative 10.3°(A)/6.5°(B), and 15.3°(A)/13.7°(B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postopera-tively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions: The similar clinical results can be ob-tained by the two kinds of posterior surgical methods for osteoporotic Ktimmell's disease. Posterior spinal shorten-ing is a better choice for patients with serious kyphosis combined with neurological deficit than the other.     

Two kinds of posterior approach for Kümmell's disease after osteoporotic thoracolumbar fracture

To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolum-bar Kummell's disease.Methods: Clinical and radiographic results of 1-seg-mental pedicle screw fixation combined with vertebroplasty (Group A, n=12) or posterior shortening osteotomy (Group B, n=16) for osteoporotic thoracolumbar Kummell's disease were analyzed retrospectively. Japanese orthopedic asso-ciation (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radio-graphic results. Complications related to operation and de-vices were also considered. Results: The follow-up period was 12-54 months (average 29 months). Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t=5.306, P<0.001). There was no sig-nificant difference between Groups A and B (t=0.618, P>0.05). The kyphosis were corrected from preoperative 33.9°(A)/37.3°(B) to postoperative 10.3°(A)/6.5°(B), and 15.3°(A)/13.7°(B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postopera-tively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions: The similar clinical results can be ob-tained by the two kinds of posterior surgical methods for osteoporotic Ktimmell's disease. Posterior spinal shorten-ing is a better choice for patients with serious kyphosis combined with neurological deficit than the other.     

Two kinds of posterior approach for Kümmell's disease after osteoporotic thoracolumbar fracture

To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolum-bar Kummell's disease.Methods: Clinical and radiographic results of 1-seg-mental pedicle screw fixation combined with vertebroplasty (Group A, n=12) or posterior shortening osteotomy (Group B, n=16) for osteoporotic thoracolumbar Kummell's disease were analyzed retrospectively. Japanese orthopedic asso-ciation (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radio-graphic results. Complications related to operation and de-vices were also considered. Results: The follow-up period was 12-54 months (average 29 months). Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t=5.306, P<0.001). There was no sig-nificant difference between Groups A and B (t=0.618, P>0.05). The kyphosis were corrected from preoperative 33.9°(A)/37.3°(B) to postoperative 10.3°(A)/6.5°(B), and 15.3°(A)/13.7°(B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postopera-tively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions: The similar clinical results can be ob-tained by the two kinds of posterior surgical methods for osteoporotic Ktimmell's disease. Posterior spinal shorten-ing is a better choice for patients with serious kyphosis combined with neurological deficit than the other.     

Two kinds of posterior approach for Kümmell's disease after osteoporotic thoracolumbar fracture

To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolum-bar Kummell's disease.Methods: Clinical and radiographic results of 1-seg-mental pedicle screw fixation combined with vertebroplasty (Group A, n=12) or posterior shortening osteotomy (Group B, n=16) for osteoporotic thoracolumbar Kummell's disease were analyzed retrospectively. Japanese orthopedic asso-ciation (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radio-graphic results. Complications related to operation and de-vices were also considered. Results: The follow-up period was 12-54 months (average 29 months). Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t=5.306, P<0.001). There was no sig-nificant difference between Groups A and B (t=0.618, P>0.05). The kyphosis were corrected from preoperative 33.9°(A)/37.3°(B) to postoperative 10.3°(A)/6.5°(B), and 15.3°(A)/13.7°(B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postopera-tively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions: The similar clinical results can be ob-tained by the two kinds of posterior surgical methods for osteoporotic Ktimmell's disease. Posterior spinal shorten-ing is a better choice for patients with serious kyphosis combined with neurological deficit than the other.     

Two kinds of posterior approach for Kümmell's disease after osteoporotic thoracolumbar fracture

To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolum-bar Kummell's disease.Methods: Clinical and radiographic results of 1-seg-mental pedicle screw fixation combined with vertebroplasty (Group A, n=12) or posterior shortening osteotomy (Group B, n=16) for osteoporotic thoracolumbar Kummell's disease were analyzed retrospectively. Japanese orthopedic asso-ciation (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radio-graphic results. Complications related to operation and de-vices were also considered. Results: The follow-up period was 12-54 months (average 29 months). Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t=5.306, P<0.001). There was no sig-nificant difference between Groups A and B (t=0.618, P>0.05). The kyphosis were corrected from preoperative 33.9°(A)/37.3°(B) to postoperative 10.3°(A)/6.5°(B), and 15.3°(A)/13.7°(B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postopera-tively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions: The similar clinical results can be ob-tained by the two kinds of posterior surgical methods for osteoporotic Ktimmell's disease. Posterior spinal shorten-ing is a better choice for patients with serious kyphosis combined with neurological deficit than the other.     

Two kinds of posterior approach for Kümmell's disease after osteoporotic thoracolumbar fracture

To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolum-bar Kummell's disease.Methods: Clinical and radiographic results of 1-seg-mental pedicle screw fixation combined with vertebroplasty (Group A, n=12) or posterior shortening osteotomy (Group B, n=16) for osteoporotic thoracolumbar Kummell's disease were analyzed retrospectively. Japanese orthopedic asso-ciation (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radio-graphic results. Complications related to operation and de-vices were also considered. Results: The follow-up period was 12-54 months (average 29 months). Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t=5.306, P<0.001). There was no sig-nificant difference between Groups A and B (t=0.618, P>0.05). The kyphosis were corrected from preoperative 33.9°(A)/37.3°(B) to postoperative 10.3°(A)/6.5°(B), and 15.3°(A)/13.7°(B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postopera-tively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions: The similar clinical results can be ob-tained by the two kinds of posterior surgical methods for osteoporotic Ktimmell's disease. Posterior spinal shorten-ing is a better choice for patients with serious kyphosis combined with neurological deficit than the other.     

髋臼骨折的手术策略

髋臼骨折位置深在，解剖复杂，手术显露和固定都非常困难。对于移位较大的髋臼骨折，闭合复位必然导致骨折畸形愈合，切开复位内固定虽然能获得解剖复位，但是手术并发症非常多。髋臼骨折无论采取哪一种方法治疗，其结局均可能为创伤性关节炎或股骨头坏死。为了更好的治疗髋臼骨折，要求骨科医师必须全面掌握髋臼的解剖结构、生物力学、骨折分类、治疗方法以及并发症的预防等基础知识。     

髋臼骨折治疗方法选择及疗效分析

目的探讨髋臼骨折的分类、治疗方法与临床疗效的关系.方法从1993年6月至2002年7月,共收治51例髋臼骨折患者,其中30例髋臼骨折采用骨牵引治疗,牵引时间为4～6周,3个月后开始负重;21例采用切开复位内固定,术前均作骨牵引,术后鼓励活动肌肉和关节,结合使用CPM机进行持续被动功能活动,2～3个月开始逐渐负重.结果44例获1.5～10年随访,其中骨牵引治疗组25例,手术治疗组19例.疗效评定参照美国矫形外科学会提出的髋关节功能评价方法,采用非手术治疗组疗效优11例,良8例,可2例,差4例;采用手术治疗组疗效优10例,良6例,可1例,差2例.结论Letournel分类中只有单纯的前后壁或前后柱骨折,骨折块小而未累及髋臼负重区的骨折,分离移位＜3 mm,才适用牵引治疗;而对于复杂的髋臼骨折或分离移位＞3 mm的单纯性骨折,只有应用手术治疗才可能有效恢复髋臼与股骨头的对合,提高临床疗效.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.