经胸病灶清除椎管前方减压加大块髂骨植骨治疗胸椎结核合并截瘫(附43例报告)

目的:对胸椎结核合并截瘫者进行病灶清除.方法:采用经胸病灶清除椎管前方减压加大块髂骨移植治疗胸椎结核合并截瘫43例,结果:术后截瘫完全恢复40例(93%).作者认为经胸病灶清除椎管前方减压能充分暴露病灶,达到彻底清除结核病灶,有效的椎管减压要求.病灶清除后,椎体间缺损大于3cm者,采用大块全板髂骨作椎体间植骨.全部病人在术后2年摄片复查,发现植骨块位置良好,髂骨块与植骨床融合.结论:大块全板髂骨作椎体间植骨抗折、抗弯曲能力强,有固定可靠,植骨融合率高等优点.

Transthoracic focal debridement and anterior decompression combining massive ilium bone graft for tuberculosis of thoracic spine complicated with paraplegia: A report of 43 cases

Forty three cases of tuberculosis of thoracic spine complicated by paraplegia were treated through transthoracic focal debridement under anterior decompression combining massive ilium bone gratf The overall recovery was obtained in 40 cases(93%) By using this operative method,the field of vision was wide and excision would be quite thorough and effective decompression could be obtained After focal debridement,interbody defects of more than 3cm in diameter need massive ilium bone graft Satisfactory positioning of the bone graft and fusion of the graft bone with the bed of the graft bone was shown in the X ray films in all cases more than two years after the operation It suggested that interbody massive ilium bone graft have following advantage:(1)a good strength against bending and fracturing;(2)reliable fixation;(3)high fusion rate