脊柱结核一期病灶清除植骨内固定术的疗效观察

One stage radical debridanent interbody fusion and instrumentation in the treainent of spinal tuberculosis

目的探讨不同节段脊柱结核外科治疗的手术策略及内固定方法的选择。方法回顾性分析2004年10月～2006年12月期间接受病灶清除、植骨融合及内固定手术治疗并获得随访的60例脊柱结核患者的临床资料,观察术后患者结核中毒症状和神经功能的改善情况,以及脊柱稳定情况及植骨成活率。结果所有患者术后结核中毒症状明显缓解或消失,神经功能明显改善,脊柱稳定性及植骨成活率显著提高,平均5个月时植骨融合,无内固定物松动、断裂,椎体高度无丢失,脊往后凸畸形改善,平均矫正角度10°。结论脊柱结核一期病灶清除植骨内固定术是安全、有效的,手术策略的制定和内固定的选择应根据病变节段、脓肿大小、范围等综合判断。

Objective To investigate the operative method and instrumentation selection in different spine segment. Methods Sixty patients,28 males and 32 females with an average age of 38 years old,were involved in this study. They accepted one - stage radical debridanent interbody fusion and instrumentation from Junuary 2003 to December 2006, and all of them were followed up after operation, the improvement of their symptom and neumlogic deficits were observed. The stability of spine and the rate of fusion were also observed. Results All the patients were followed up with an average 10 months. Their symptoms disappeared or relieved significantly after operation. And their neumlogic function improved one or more than one degree. The average fusion time is 5 months. The instrumentation did not loose or break and the height of the veterbra body did not lose. Most of the kyphosis deformity was corrected differently and the average was 10°. Conclusions One stage radical debridanent interbody fusion and instrmnentation in the treainentof spinal tuberculosis is safe and valid. Different operation should be selected according to the spinal segment.