Ⅰ期病灶清除植骨内固定治疗胸腰椎结核

目的：探讨Ⅰ期手术脊柱内固定治疗胸腰椎结核的疗效。方法：2002年1月-2004年6月手术治疗胸腰椎结核31例，其中胸椎15例，胸腰椎5例，腰椎11例；平均年龄31．6岁；病程4个月～2．8年，平均9．2个月。全部病例经彻底病灶清除后Ⅰ期植骨内固定，前路固定21例，后路固定10例。结果：术后随访平均13．6个月（4个月～2年），植骨全部骨性融合，后凸畸形矫正满意，有神经症状患者得到改善，无感染和窦道形成。结论：彻底病灶清除是外科治疗脊柱结核的主要方法，在此基础上引进脊柱内固定系统治疗脊柱结核增加了术后节段稳定性，植骨块牢固，植骨融合率提高，后凸畸形矫正满意。Ⅰ期内固定安全可靠。

Treatment of thoracic and lumbar tuberculosis by removing lesion of tuberculosis and bone graft with internal fixation at one stage

Objective:To explore the clinical effect for the treatment of thoracic and lumbar tuberculosis with internal fixation at one-stage.Methods:From Jan.2002 to Jun.2004,31 patients with thoracic and lumbar tuberculosis were treated with removing lesion of tuberculosis and bone graft and internal fixation.The average age was 31.6 years old and the average progress was 9.2 months(range from 4 months to 2.8 years).Of them,thoracic spine 15 cases,thoracic and lumbar 5 cases and lumbar vertebra 11 cases.Results:All the patients were followed up from 4 months to 2 years with an average 13.6 months(4 months2 years).Bone graft obtained fusion,correction of deformity was satisfactory,nerve symptom improve.Not infections and sinus tract were found in all the patients.Conclusion:Removed lesion of tuberculosis is the main method for the treatment of spinal vertebra tuberculosis.On the basis of the operation,internal fixation can increase stability of the spine,improve the rate of bony union,obtain satisfactory correction for deformity,which was safe and reliable at one-stage.