椎弓根系统内固定同期前路植骨治疗胸腰椎结核

Transpedicular Screw System Internal Fixation and Anterior Interbody Fusion in the Tuberculosis of Thoracic and Lumbar Spine

目的 探讨应用椎弓根系统内固定同期前路植骨融合术治疗胸腰椎结核的临床效果。方法 1998年 2月至2 0 0 3年 2月采用后路椎弓根系统内固定同期前路植骨融合的胸腰椎结核患者 36例 ,包括植骨融合率 ,截瘫恢复情况和后凸畸形矫正情况。随访时间 1～ 4 a,平均 2 .6 a。结果 所有患者均显示骨性融合 ,融合时间平均 7.9个月 ;2 4例合并截瘫患者中 ,症状改善 2 2例 ,改善率 91.7% ;术后后凸畸形平均矫正 2 9.4°,1～ 4 a后随访 ,后凸角度平均丢失 2 .1°。结论 后路椎弓根系统内固定同期前路植骨融合能加强脊柱的稳定性 ,促进骨融合和截瘫恢复 ,矫正后凸畸形。

Objective To study the clinical effectiveness of tr anspedicular screw system internal fixation and anterior interbody fusion procedure for treating thoracic and lumbar spinal tuberculosis. Methods Between February 1998 and February 2003, posterior transpedicular screw system internal fixatiom and anterior interbody fusion procedures were used in 36 patients suffering from thoracic and lumbar spinal tuberculosis.All of them were involved in a longitudinal study with follow-up for a mean of 2.6(1～4) years postoperatively. Results All of the results showed successful interbody fusion. Among 24 cases of Pott′s paraplegia, 18 cases were completely recovered, 4 cases were partly recovered, the rate of recovery was 91.7%. The average immediate postoperative correction of kyphosis angle was 29.4 degree, the average loss of correction was only 2.1 degree at final follow-up. Conclusion Transpedicular screw system internal fixation and anterior interbody fusion procedure are helpful in strengthening the stability of the spine in thoracic and lumbar spinal tuberculosis, providing successful interbody fusion and recovery of Pott′s paraplegia, correcting the kyphosis, and preventing progression of kyphosis.