短程化疗加前路病椎切除植骨内固定术治疗脊柱结核

Treatment of spinal tuberculosis with short-course chemotherapy and excision of pathologic vertebrae and fusion with internal instrument

目的：探讨短程化疗联合病椎部分切除植骨内固定手术的临床疗效。方法：对46例脊柱结核行2HRZ（E/S）/4HR化疗,前路病变椎体部分切除、大块髂骨支撑植骨、植骨钛板内固定。观察术后和随访期间患者结核中毒症状和神经功能的改善情况,植骨融合情况及治愈率。结果：1.2~5年随访,脊柱结核均治愈,无全身及局部并发症,脊髓功能损伤恢复,植骨块愈合,后凸畸形部分矫正,未发现钢板松动、断裂。结论：短程化疗加病椎切除内固定治疗脊柱结核,可加强脊柱稳定,改善畸形,减少复发和药物副作用。

Objective： To evaluate the clinical efficacy of short-course chemotherapy and excision of the pathologic vertebrae. Methods..46 cases of spinal tuberculosis were treated with shortcourse chemotherapy with 2HRZ （E/S）/4HR. All patients underwent anterior excision of the affected vertebrae , large lilac strut graft and anterior plat fixation. The observed indices included clinical manifestation improvements of TB toxic symptoms, nerve recovery and bony fusion. Results.. All patient were followed-up for 1. 2-5year. Spinal tuberculosis completely cured. No significant systemic and local complications were found, The patient with neurological deficits recovered and the grafted bony fused completely. The hypnoses were corrected partly, No looses or break of the plat was found. Conclusion.. Treatment of spinal tuberculosis with anterior excision of pathologic vertebrae, large lilac strut graft, anterior plat internal instrument fixation and short-course chemotherapy achieved excellent therapeutic effects, reconstructed spinal stabilities early, corrected deformity, sped bony fusion and lessened recur fence and drug toxicity.