一期清除病灶、自体植骨并内固定治疗胸腰椎结核

Anterior interbody autografting and internal fixation for primary surgical management of thoracolumbar spinal tuberculosis

目的:探讨一期病灶清除、自体植骨并内固定治疗胸腰椎结核的安全性及疗效。方法:2002年1月～2004年1月我院收治胸腰椎结核患者28例,采用一期前路病灶清除、椎体间自体植骨并腰椎"Z"形前路钛钢板内固定治疗。结果:经平均21个月的随访,28例患者脊柱结核均治愈,无局部结核复发,植骨全部骨性融合,融合时间平均为4.6个月,术后后凸矫正角度平均27°,1～3年随访后平均丢失2.3°。FIM评分术前平均为62.86分,术后平均为83.38分,差异有统计学意义(P<0.05)。结论:一期清除病灶、自体植骨并局部植入钛质内固定治疗胸腰椎结核是安全和有效的。

Objective：To evaluate the effect and safety of therapy of primary anterior debridement,inetrbody autografting and Z-plate fixation in the treatment of spinal tuberculosis.Methods：Twenty-eight cases of thoracolumbar spinal tuberculosis were retrospectively analyzed,which were treated with primary anterior debridement, interbody autografting and Z-plate fixation from January 2002 to January 2004.Results：All the 28 cases healed without any recurrence after follow-up for an average of 21 months. Spinal fusion occurred in 4.6 months on average after surgery and 27 degrees of kyphosis correction was achieved, while 2.3° was lost 1-3 year later. The average of FIM score was 83.38 after treatment, which was highter than the preoperative score（62.86） significantly（P〈0.05）.Condusion：The method of debridement the tuberculose focus primary, auto-grafting and Z-plate fixation is safe and effective in the treatment of spinal tuberculosis.