一期后路病灶清除内固定椎体间植骨治疗脊柱结核

目的探讨一期后路病灶清除内固定椎体间植骨融合术治疗脊柱结核的临床效果。方法 2006年7月~2013年9月,对36例胸腰段脊柱结核患者均采用一期后路病灶清除内固定椎体间植骨融合术治疗。后路内固定采用椎弓根螺钉系统,病灶清除后采用结构性支撑,自体大块髂骨植骨9例,椎间融合器椎间植骨并自体髂骨骨粒植骨27例。结果平均随访22个月,所有病例植骨均骨性融合,内固定无松动、断裂,3例有神经功能障碍者恢复良好。结论脊柱结核手术治疗中,后路病灶清除内固定是安全有效的。后路植骨融合率高,是一种较好的手术方式。

One-stage posterior debridement and interbody fusion with internal fixation for spinal tuberculosis

Objective To evaluate the clinical effects of one-stage posterior debridement and interbody fusion with internal fixation for spinal tuberculosis. Methods From July 2006 to September 2013, a retrospective ananlysis was performed in 36 cases of thoracolumbar spinal tuberculosis patients who had undergone one-stage posterior debridement and interbody fusion with internal fixation. Posterior internal fixation by pedicle screw system was performed after the debridement of the structural support: autologous iliac bone graft in 9 cases, fusion cage interbody bone with autologous iliac bone graft in 27 cases. Results The average follow-up of 22 months, interbody fusion and internal fixation without loosening or interruption were performed in all cases, 3 cases with functional disturbance had good recovery. Conclusion The one-stage posterior debridement and interbody fusion with internal fixation for spinal tuberculosis is a safe and effective surgery which interbody fusion rate is high.