一期前路手术内固定珊瑚人工骨植入治疗脊柱结核

Simultaneously anterior internal fixation combined with coralline hydroxyapatite transplantation in the treatment of spinal tuberculosis

目的探讨脊柱结核手术治疗中一期前路病灶清除椎体间植珊瑚羟基磷灰石人工骨融合同时前路内固定手术治疗的安全性、有效性。方法总结18例脊柱结核患者,采用一期前路病灶清除,椎体间植珊瑚羟基磷灰石人工骨融合,前路内固定器内固定治疗。结果平均随访25个月,18例患者血沉恢复正常时间平均为术后2个月,无局部结核复发、窦道形成,植骨全部骨性融合,融合时间平均为术后5.8个月,后凸畸形矫正平均较术前纠正23.6°。神经功能全部得到显著改善。结论脊柱结核内固定可有效纠正脊柱后凸畸形,早期重建脊柱稳定性,有助于植骨融合和减少结核复发,在结核病灶彻底清除的同时,植珊瑚羟基磷灰石人工骨是安全有效的。植骨替代材料,珊瑚羟基磷灰石人工骨的应用,避免了取自体骨带来的并发症。

Objective To explore the safety and effect in the treatment of spinal tuberculosis by simultaneously anterior internal fixation combined with coralline hydroxyapatite. Methods Retrospective study of 18 spinal tuberculosis treated by simultaneously focus eliminate,coralline hydroxyapatite transplantation between vertebra body and anterior internal fixation. Results After follow up mean 25 months,ESR in 18cases became normal after 2 months of surgery. No recurrence,no sinus were formed in local. All transplanted material healed with surrounding bone in 5.8 months. The spinal kyphotic angle reduced 23.6° and neurological function had greatly improved after operation. Conclusions The internal fixation can correct spinal kyphotic deformity,establish the stability of the spinal column in early stage,promote the healing of transplanted materials reduce the recurrence of tuberculosis. The coralline hydroxyapatite transplantation, avoid the complications of autologous bone transplantation,it is safe and effective in the complete eliminated focus.