前路病灶清除植骨内固定治疗脊柱结核

目的探讨前路一期病灶清除、植骨内固定治疗脊柱结核的效果。方法对37例前路病灶清除、植骨内固定的脊柱结核病例进行回顾性分析。男31例,女6例。颈椎结核3例,胸椎结核9例,胸腰段结核17例,腰椎结核8例。观察术后神经功能恢复、畸形矫正、植骨融合、结核治愈及并发症。结果术后12个月31例骨性融合,24个月全部病例骨性融合。胸椎、胸腰椎、腰椎后凸畸形角分别纠正平均27°、24°、5°,随访中矫正后凸角度无明显丢失,无内固定松动,断钉发生,结核无复发。结论前路病灶清除、植骨内固定治疗脊柱结核病灶清除彻底,脊髓减压充分,能较好地纠正后凸畸形,稳定病椎,有利于植骨融合和病灶愈合,效果满意。

Anterior Debridement and Fusion with Internal Fixation in the Treatment of Spine Tuberculosis

Objective To review the efficacy of anterior debridement and fusion with internal fixation in the treatment of spine tuberculosis.Method A total of 3 patients with cervical,thoracic and lumbar were operated with a combination of debridement and internal fixation with Orion,Z-plate,Ventrofix,K-plate or TRSH instruments.Results 31 cases got solid fusion in 12 months,all of them in 24 months,Kyphosis deformity was corrected without obvious angle loss.There was no recurrence of tuberculosis,screw loosening or breakage of plate.Conclusion patients with spine tuberculosis can be successfully treated combination anterior debridement and fusion with internal fixation.Bone graft plus internal fixation can correct deformity and strengthen the stability,and lessen the pressure of spine.