胸腰椎结核前路病灶清除植骨内固定与非内固定组的疗效对比分析

Contrastive Analysis of Thoracolumbar Spinal Tuberculosis Treated by Anterior Radical Debridement with Iliac Grafting and Internal Fixation or Without Internal Fixation

目的探讨前路病灶清除,一期植骨内固定治疗胸腰椎结核的临床效果。方法胸腰椎结核60例,随机分为两组。其中32例(观察组)采用前路病灶清除,一期植骨内固定治疗;28例(对照组)采用前路病灶清除,一期植骨治疗。观察术后畸形纠正情况、植骨融合速度以及治愈率。结果观察组后弓角较术前纠正度数18°,对照组纠正5°;观察组植骨的融合速度快于对照组,两组比较有显著性差异(P<0.05)。观察组治愈率为100%,对照组为82.1%,两组比较有显著性差异(P<0.05)。结论前路一期病灶清除植骨内固定治疗胸腰椎结核,可重建脊柱的稳定性,利于结核病灶的稳定与修复,减少结核复发,提高治愈率,并能明显改善畸形。

Objective To discuss the clinical efficacy in treatment of the thoracolumbar spinal tuberculosis with radical debridement, iliac grafting and internal fixation. Methods Sixty patients with thoracolumbar spinal tuberculosis were treated. Thirty - two patients were treated with radical debridement, iliac grafting and internal fixation while the other patients were treated without internal fixation. Resuits The kyphotic deformity was corrected on an average of 18 degrees in the patients undergoing internal fixation and 5 degrees in other patients （P 〈 0.05）. The patients undergoing internal fixation had a higher recovery rate 100 % VS 82.1%, and quicker speed than patients without internal fixation （P 〈 0.05）. Conclusion Internal fixation plays an important role in surgical treatment of thoracolumbar spinal tuberculosis by reconstructing spinal stability early, correcting deformity, speeding bony fusion, and lessening relapse.