经前后路联合手术治疗L_5S_1椎体结核

Treatment of L_5S_1 tuberculosis by one-stage posterior internal fixation together with anterior lesion clearance and bone grafting

目的探讨一期经前路病灶清除后路植骨内固定治疗L5S1椎体结核的临床疗效。方法对40例L5S1椎体结核患者，采用一期经前路病灶清除椎体间植骨加后路椎弓根螺钉内固定植骨融合治疗。结果所有患者随访6—24个月，35例植骨融合良好，5例融合欠佳；有1例出现尿路感染。结论一期经前路病灶清除椎体间植骨加后路椎弓根螺钉内固定椎板植骨治疗L5S1椎体结核能在彻底清除病灶的前提下保证脊柱的稳定性，提高植骨块的融合率和缩短患者卧床时间。

Objective To investigate the clinical effect of one-stage posterior internal fixation together anterior lesion clearance and bone grafting in the treatment of L5S1 tuberculosis. Methods Forty cases of L5S1 tuberculosis were treated by posterior transpedicular instrumentation together with anterior lesion clearance and bone autograft. Results All the patients were followed up for 6 - 24 months with an average of 14 months. The results of fusion were excellent and good in 35 patients,and fair in 5 patients. Urinary tract infection was found in 1 patient. Conclusions In the treatment of L5S1 tuberculosis, posterior internal fixation together with anterior lesion clearance and bone grafting simuhaneously can effectively immobilize the compromised segment, raise the fusion rate and shorten the time lying in bed.