前路病灶清除、钛网充填植骨及内固定治疗胸腰椎结核

目的探讨前路病灶清除、钛网充填植骨重建联合内固定术在胸腰椎结核治疗中的临床疗效。方法对24例胸腰椎结核患者采用前路病灶清除及钛网充填植骨加内固定结合正规抗结核化疗,观察术后伤口愈合、结核中毒症状、神经功能的恢复、固定融合及复发情况。结果所有患者随访6～32个月,平均18.5个月,无复发。刀口均一期愈合。术后全身症状及局部疼痛消失;神经症状有不同程度恢复;随访期间未见内固定松动及钛网明显移位。结论病灶清除钛网植骨融合内固定术结合规范抗结核化疗治疗胸腰椎结核的临床疗效显著、可靠。

Treatment of Thoracolumbar Spinal Tuberculosis by the Combined Application of Internal Fixation,Anterior Radical Debridement and Titanium Mesh Bone Fusion

Objective To study the clinical outcome in treating the thoracolumbar spinal tuberculosis with debridement titanium meshes bone grafting and internal fixation.Methods 24 cases of thoracolumbar spinal tuberculosis were retrospectively analyzed.All patients received anterior debridement,titanium meshes bone grafting and internal fixation,along with strict antituberculosis chemical therapies.Data evaluation included posterior incision concrescence,recovery of tuberculosis symptoms and neurologic function,bone fusion and the recurrence of spinaltuberculosis.Results No recurrence was found in the follow-up period extending from 6 months to 32 months with an averaging of 18.5 months.All the incisions acquired primary healing,the systematic and local symptoms were released postoperatively,neurological function recovered in different degrees;neither internal fixation loosening nor obvious titanium mesh cage shifting was found.Conclusion The posterior fixation,anterior radical debridement and titanium mesh bone fusion is an effective and reliable method in the treatment of thoracolumbar spinal tuberculosis.