一期前路病灶清除钛网植骨后路内固定治疗胸腰椎结核并后凸畸形66例疗效观察

目的观察一期前路病灶清除钛网植骨后路内固定术治疗胸腰椎结核并后凸畸形的临床疗效。方法对66例胸腰椎结核并后凸畸形患者在术前进行至少3周正规抗结核药物治疗后行病灶清除、椎间植骨及后路内固定术,根据术后后凸畸形的矫正角度及Frankel分级评价效果。结果对66例患者随访9~18(12±2)个月,所有患者无局部复发及窦道形成,术前术后Cobb角差异有统计学意义(P<0.05),Frankel分级与术前比较均有1~3级恢复。结论一期前路病灶清除、钛网植骨、后路内固定手术具有病灶清除彻底,植骨融合内固定可靠,畸形矫正理想等优点。

Clinical effect of one-stage anterior radical debridement,titanium mesh bone grafting and posterior internal fixation on 66 cases of thoracolumbar spinal tuberculosis with kyphotic deformity

Objective To study the clinical effect of one-stage anterior radical debridement, titanium mesh bone grafting and posterior internal fixation on thoracolumbar spinal tuberculosis with kyphotic deformity. Methods A total of 66 patients with thoracolumbar spinal tuberculosis with kyphotic deformity, who had been treated by at least 3 weeks＇ formal anti-tuberculosis drug therapy, underwent radical debridement,interbody fusion and internal fixation. Kyphosis correction and Frankel grade were used in the evalu- ation of the results. Results After 9 - 18 （ 12 ＋- 2） months＇ follow-up, there were no local reemxence and sinus formation in all the 66 patients. The difference in Cobb angle was significant between pre-and postoperation （ P 〈 0.05 ）. The recovery was evalua- ted as Frankel grade 1 - 3. Conclusion The operation by one-stage anterior radical debridement, titanium mesh bone grafting and posterior internal fixation has the characteristics of thorough debridement, reliable bone graft fusion and internal fixation, as well as satisfactory correction of deformity. It is a kind of effective treatment method to thoracolumbar spinal tuberculosis with kyphotic deformity.