前路一期病灶清除植骨U型钛板内固定治疗腰骶段结核

目的总结经腰骶椎前路一期病灶清除植骨U型钛板内固定治疗腰骶段结核的临床疗效。方法 2005年1月～2009年9月,采用经腰骶椎前路一期病灶清除植骨U型钛板内固定治疗腰骶段结核21例,其中男12例,女9例。19例有不同程度腰骶部持续疼痛,11例伴下肢放射痛,8例单侧下肢肌力、感觉减退,2例伴鞍区麻木。术前使用四联抗结核2～4周,待结核中毒症状改善或血沉呈下降后行手术治疗。结果 21例均获随访,随访时间11～38个月,平均20个月。12例男性患者均无勃起功能障碍、逆行射精等症状。下肢放射性疼痛、鞍区麻木症状消失。2例轻度腰骶部疼痛,对症处理后疼痛缓解。术后6个月均获骨性融合,手术治愈率90.4%。结论腰骶段椎体前方入路一期病灶清除植骨U型钛板内固定治疗腰骶段结核,可重建脊柱稳定性,获得良好的骨性融合。

Anterior primary debridement,bone grafting and internal fixation for lumbosacral spinal tuberculosis

Aim To evaluate the clinical outcomes of primary anterior radical debridement,bone autograft,and internal fixation in treating tuberculosis of the lumbosacral segments.Methods From January 2005 to September 2009,21 patients with tuberculosis of the lumbosacral segments were treated with anterior radical debridement,autologous iliac bone graft,and internal fixation with titanium plate,including 12 males and 9 females.All patients experienced toxic symptoms of the tuberculosis and 19 cases experienced various...