经前路病椎次全切除钛网植骨内固定治疗胸腰椎结核

目的探讨经前路病椎次全切除加钛网植骨内固定治疗胸腰椎脊柱结核的临床疗效。方法对13例胸腰椎脊柱结核,患者均行前路病椎次全切除、钛网植骨内固定手术治疗,采用Frankel分级结合X线片判断疗效。结果所有病例作半年以上随访,每3个月复查X片,术后神经功能障碍者均恢复到Frankel E级,13例植骨完全融合,后凸畸形基本矫正,内固定无松动及断裂,无结核复发。结论经前路病椎次全切除、钛网植骨、内固定治疗胸腰椎结核具有术野清晰、病灶清除彻底、植骨融合可靠、内固定稳定、畸形矫正满意、植骨融合率和治愈率高的特点,是目前脊柱外科治疗胸腰椎脊柱结核的有效方法,值得在临床推广应用。

The pathologic vertebrae subtotal resection of titanium mesh bone graft and internal fixation in treatment of thoracolumbar spinal tuberculosis

Objective To discuss the clinical curative effect of anterior vertebral subtotal resection and titanium mesh bone grafting and internal fixation for the treatment of thoracolumbar spinal tuberculosis.Methods From September 2004 through March 2011,In our hospital,13 cases of thoracolumbar spinal tuberculosis were operated using anterior vertebral subtotal resection,titanium mesh bone grafting,and internal fixation.The clinical curative effects were classified by frankel system and X-ray.Results 13 cases were followed up for more than half a year,and X-ray reviewed every three months,Postoperative neurological disorder are restored to Frankel E level.In all cases bone graft fusion appears,protrusion deformity was mostly corrected;internal fixation without loosening and fracture;no tuberculosis relapse.Conclusion The operation of thoracolumbar spinal tuberculosis by the pathologic vertebrae subtotal resection,titanium mesh bone grafting,and internal fixation has the characteristics of clear surgical field,thorough debridement,and stable,reliable bone graft fusion internal fixation.The operation satisfies the correction of deformity,and the bone graft fusion rate and cure rate are high.The operation is an effective surgical treatment of thoracolumbar spinal tuberculosis.