同时USS固定矫形植骨后路病灶清除治疗脊柱结核

One stage operation of USS internal instrumentation and transplantation of bone and posterial route debridement of tuberculosis spinal lesions

目的 :研究治疗脊柱结核一期完成的方法 ,同时还要植骨病灶的清除、减压 ,且一个切口完成。方法 :取俯卧位 ,后正中入路 ,显示病灶上下 2个正常椎体的椎板及横突 ,在胸椎需要切除左右肋骨后段 ,先将椎弓根固定系统 (USS)固定 ,矫正后凸畸形 ,并撑开 ,恢复椎间隙高度 ,在病椎两侧 ,椎弓根下方分离 (保护神经根 )达病灶 ,并彻底清除 ,行椎间植骨 ,椎板亦植骨。结果 :2 1例患者的病灶得到彻底清除。脊柱畸形的度数由术前 3 5°矫正到术后的 8 7° ,椎体间隙的高度 ,由术前 5 9 5 % ,到术后 86 7% ,骨融合良好 ,术后病灶无复发。结论 :此手术入路简单 ,须保护神经根 ,病灶及坏死的椎间盘得到清除 ,后凸矫正满意 ,融合良好 ,手术一次完成 ,缩短了病程 ,减少了花费 ,为较好的治疗脊柱结核的手术方式。

Objective:To study the one stage operation of spinal tuberculosis which included USS internal instrumentation and transplantation of bone and getting rid of focus of infection reduction of pressure,all the operations were finished in the same incision Method:To incise the skin at center and reveal the lamina arcus vertebrae and processus transversus of the lower and the upper normal corpus vertebrea at the thoracic verbebra need to resect the posterior of tow sides ribs At first to use USS to correct the deformity of the spine,bolster and fix the spine tosever the nerve under the arcus verbebrae to reach the focus of infection to get rid of focus of infection and transplant the ilium between the lamina arcus vertebrae corpus vertebrea Result:The focus of infection of 21 cases were gotten clearly rid of,the deformity angle was corrected from 35° before operation to 8 7° after operation The height of intervertebrale,recovered 27 2%,transplanted bone fused well and the focus of infection did not relapse Conclusion:The operation way is simple and the focus of infection can get clearly rid of and good fusion The all operations are finished at onetime,it shortens the course of disease and reduces the cost,the operation way is an ideal method to treat the tuberculosis of spine