前路病灶清除植骨内固定治疗脊柱胸腰段结核

Anterior Focus Debridement with Autogenous Bone Graft and Internal Fixation in the Treatment of Thoracolumbar Tuberculosis

目的对前路病灶清除植骨,同期内固定治疗脊柱胸腰段结核的临床疗效进行探讨。方法2001年1月至2005年2月,我科对11例脊柱胸腰段结核患者,采取胸、腹膜后入路,病灶清除植骨,同期行Z-plate内固定治疗。结果11例患者经过1.5-4年的随访,腰痛症状均明显缓解,植骨块全部融合,融合时间5-6个月,后凸角矫正8°-17°。无内固定松动断裂。结核病灶无复发。结论前路病灶清除植骨,同期内固定治疗脊柱胸腰段结核,可较彻底清除病灶,有效椎管减压,部分矫正畸形,恢复脊柱的稳定性,固定牢靠,有利于患者早期下床功能锻炼,是一种可行的、疗效较好的治疗方法。

Objective To assess the clinical effect of anterior focus debridement with autogenous bone graft and internal fixation in the treatment of thoracolumbar tuberculosis. Methods 11 patient with thoracolumbar tuberculosis were treated by focus debridement combined with autogenous bone graft and Z-plate internal fixation through thoracolumbar retroperitoneal approach. Results 11 cases were followed up from 1 year and a half to 4 years. The lumbodorsal pain was obviously relieved. The bone autograft got solid fusion in 5- 6 months. The corrective angle of kyphosis was 8-17°. No loosening and breakage of internal fixation was found. No relapse of the spinal tuberculosis healed occurred. Conclusion Focus debridement with bone autograft and internal fixation was feasible and effective in the treatment of thoracolumbar tuberculosis. It can complete decompression of spinal canal and correction of kyphosis partly and recover stability of spine. The patients can take exerise out of bed early.