前路一期病灶清除植骨内固定治疗胸腰椎结核

目的探讨前路一期病灶清除植骨内固定治疗胸腰椎结核的临床疗效。方法 2005年1月～2010年1月采用前路一期病灶清除植骨内固定治疗34例胸腰椎结核患者,术前四联抗结核化疗4～6周,术中病灶清除取髂骨或多根肋骨植骨,钉棒或钉板内固定。术后卧床8～12周,继续正规化疗12～18月。结果本组病例获得16～30个月随访,内固定无松动、脱落,后凸畸形矫正满意,局部病灶无复发,腰背疼痛症状消失。结论对于胸腰椎结核患者行前路一期病灶清除植骨内固定可彻底地清除病灶,重建脊柱稳定性,矫正和预防脊柱后凸畸形疗效满意。

Anterior one-stage lesions removal, bone grafting and internal fixation for thoracolumbar spinal tuberculosis

Objective To discuss the clinical efficacy of thoracolumbar spinal tuberculosis by anterior one-stage debridement,bone grafting and internal fixation.Methods From Jan 2005 to Jan 2010,34 cases with thoracolumbar spinal tuberculosis were treated by anterior one-stage debridement,bone grafting and internal fixation.All cases received four antituberculosis medication with four kinds of drugs for 4~6 weeks preoperatively,and the lesions were completely removal intraoperatively,iliac or ribs were used to graft,and screw-plate or screw-rod system fixation was applied.All the cases lay in bed for 8~12 weeks postoperatively,and the regular chemotherapy was continued for 12~18 months.Results All the cases were followed up for 16~30 months,no internal fixation loose and shed,kyphosis were prevented and satisfied,lesions have not recrudesced,back pain symptoms disappeared.Conclusion Treatment of thoracolumbar spinal tuberculosis by anterior one-stage lesions removal,bone grafting and internal fixation can compeletely removal the lesions,reconstruct spinal stability,correct and prevent kyphosis,and have excellent clinical outcome.