胸、腰椎脊柱结核一期病灶清除、前方钛网支撑矫形内固定临床研究

目的：探析一期胸、腰椎结核植骨融合内固定、矫正脊髓前方畸形、脊髓减压、清除病灶的临床效果.方法：入选一期胸、腰椎脊柱结核患者36例,将其随机分为两组各18例,两组术前均进行14d三联化疗药物疗法,观察组进行植骨融合内固定、矫正脊髓前方畸形、脊髓减压、清除病灶疗法,对照组行前后路联合疗法,即后路内固定、前路清除病灶,植骨融合,比较两组临床疗效及各手术参数指标变化.结果：观察组治疗后血沉变化情况、Cobb角显著优于对照组（P＜0.05）;观察组各手术参数指标变化显著优于对照组（P＜0.05）.结论：一期胸、腰椎结核进行清除病灶前方钛网支撑矫正畸形,可有效避免治疗中内固定及支撑物的并发情况,临床疗效确切,是一期胸、腰椎结核治疗的首选方案,值得临床推广.

Focus Debridement,Anterior Titanium Mesh Support,Deformity Correction and Internal Fixation for Treatment of First-Stage Thoracolumbar Spinal Tuberculosis

Objective：To discuss the clinical effect of bone graft fusion internal fixation, anterior spinal deformity correction, spinal cord decompression and focus debridement for treatment of first-stage thoracolumbar spinal tuberculosis. Methods：36 patients with first-stage thoraeolumbar spinal tuberculosis were randomly divided into 2 groups both with 18 cases. Both groups were given 14d of triple chemotherapy before operations. Observation group was given treatment of bone graft fusion internal fixation, anterior spinal deformity correction, spinal cord decompression and focus debridement while control group was given treatment of combination ther- apy of anterior and posterior approach, including posterior approach internal fixation, anterior approach focus debridement and bone graft fusion. Clinical effects and operation parameter changes of the 2 groups were compared. Results： After treatment, ESR change condition and Cobb angle of observation group was better than control group （P〈0.05） ; operation parameter changes of observation group was better than control group （P〈0.05）. Conclusion：Focus debridement, anterior titanium mesh support,deformity cot rection and internal fixation for treatment of firsvstage thoracolumbar spinal tuberculosis can effectively avoid complications of inter- nal fixation and support during treatment. It has accurate clinical effect and can be the best treatment scheme for first-stage thoraco- lumbar spinal tuberculosis and should be popularized clinically.