脊柱结核手术中的内固定应用及术式选择

目的探讨内固定在脊柱结核手术中应用价值及应用方式.方法对26例患者采用4种不同术式:①后路病灶清除植骨,同期经椎弓根内固定;②前路病灶清除植骨,同期后路经椎弓根内固定;③前路病灶清除植骨,同期前路钢板内固定;④前路病灶清除植骨,同期前路单钉棍系统内固定.结果经过12个月以上的观察,病灶静止,植骨融合,内固定无松动、断裂,后突畸形矫正无丢失.结论彻底清除病灶,合理的使用内固定,能提高脊柱结核的治疗效果.

Application of internal fixation and operative method selection in spinal tuberculosis

Objective To study the value of internal fixation and applicative methods in spinal tuberculosis. Methods 26 cases were treated with four different methods: 1. Posterior focus elimination, bone grafting and one-stage posterior transpedicle instrumental fixation; 2. Anterior focus elimination, bone grafting and one-stage posterior transpedicle instrumental fixation; 3. Anetrior focus elimination, bone grafting and one-stage anterior plate fixation; 4. Anerior focus elimination, bone grafting and one-stage anterior fixation with single screw-rod system. Results All cases were followed up for over 12 months. There was no recurrence of tuberculosis, screw loosening or breakage of plate. The kyphotic deformity was corrected without angle loss. Conclusion The surgical technique of one-stage debridement with correction, instrumentation and spinal fusion is an effective method to treat spinal tuberculosis.