116例短节段脊柱结核一期前路手术临床分析

目的：探讨一期前路病灶清除椎间植骨融合内固定术治疗短节段脊柱结核的临床效果。方法：我院116例脊柱结核患者采用一期前路病灶清除、自体肋骨或髂骨植骨、钛钢板短节段内固定治疗。结果：116例均获得随访，随访时间6-48个月，平均18个月。切口一期愈合107例，形成皮肤窦道延期愈合9例。115例均达到临床治愈，1例半年后因结核性脑膜炎死亡。42例脊柱后凸平均矫正11°。椎间植骨6个月以上均获骨性融合，植骨块无移位和吸收，11例不全截瘫者术后3-12个月完全恢复。结论：短节段脊柱结核一期行前路病灶清除、自体骨植骨钛钢板短节段内固定可有效矫正后凸畸形，重建脊柱稳定性，获得骨性融合，临床效果满意。

CLINICAL ANALYSIS OF 116 CASES SHORT SEGMENTAL SPINAL TUBERCULOSIS WITH ONE STAGE ANTERIOR OPERATION

Objective：To investigate the clinical effects of treating short segmental spinal tuberculosis with debridement, interbody fusion and internal fixation in one stage.Methods：116 spinal tuberculosispatientsinourhospitalwere treated with anterior debridement, autogenous rib
or iliac bone graft and titanium plate fixation. Results：116 patients were all followed up for 6-48 months, mean 18 months. Operative incision of 107 cases were primary healing, 9 cases formed dermal sinus and delayed healing. 115 cases achieved clinical cure, and 1 case died because of meningitis after a half year. The kyphos of 42 cases were corrected 11°. The patients obtained bone fusion more than 6-month after interbody fusion, and the bone graft had no displacement and absorption. 11 cases with incomplete paraplegia complete recovered 3-12 months after operation. Conclusions： Treating short segmental spinal tuberculosis with anterior debridement, autogenous bone graft and titanium plate fixation can correct kyphos effectively, reconstruct spinal stability, obtain bone fusion; so the clinical effects are satisfactory.