前路病灶清除加钛网植骨、Z-plate内固定治疗多节段腰椎结核临床观察

The Clilnical Observation of Using Anterior Focal Cleaning with Titanium Mesh Cage Bone-graft, Z-plate Interfixation to Cure Multi-level Lumber Tuberculosis

目的：探讨前路病灶清除加钛网植骨、Z形前路钢板内同定治疗多节段腰椎结核的意义及疗效。方法：总结2002—2006年期间收治的12例多节段腰椎结核患者，并采用前路病灶清除，椎体间钛网植骨、Z形前路钢板内固定进行治疗。结果：随访8-29个月（平均17个月），脊髓神经功能得到不同程度的恢复，植骨融合满意，钛网无松动、移位和塌陷，无内固定失败和脊柱结核复发，后凸角度平均矫正16．5（°）。2年后随访患者临床症状好转，脊柱畸形矫正情况满意。结论：前路病灶清除加钛网植骨、Z—plate内固定治疗多节段腰椎结核的术式有术野显露清楚、病灶清除更彻底、脊柱稳定性重建可靠、植骨融合率和结核治愈率高等特点，是目前外科治疗多节段腰椎结核的可靠方法之一。

Objective To discuss the significance and effect of the treatment of multi-level lumber tuberculosis by using anterior focal cleaning with titanium mesh cage bone-graft, Z-plate interfixation. Methods Summarizing 12 multi-level lumber tuberculosis patients who were cured by anterior focal cleaning with titanium mesh cage bone-graft, Z-plate interfixation from 2002-2006. Results The followed up time was 8-29 months （mean 17 months） and the pations＇ nervous function were gained different extent recovery; the fusion of bone-graft was satisfied; the titanium mesh cages weren＇t loose, shifted and collapsed. There were no interfixations failure and spinal tuberculosis relapsed, the average angle of kyphosis was corrected by 16.5°. By 2 years followed up, the patients＇ deformity of spine were corrected satisfactorily. Conclusion Using anterior focal cleaning with titanium mesh cage bone-graft, Z-plate interfixation to cure multi-level lumber tuberculosis is one of very reliable method in modern surgical curing multi-level lumber tuberculosis, it has the characteristics of the exposing is clear; the focal cleaning is very thorough; the rebuilding of spine is stable; the rate of the fusion of bone-graft and the recovery of tuberculosis is high.