侧前路单钉棒系统内固定治疗多发胸椎结核

Operation of latero-anterior internal fixation by one nail-stick system for treatment of thoracic spinal tuberculosis.

目的探讨侧前路单钉棒系统内固定肋骨植骨治疗多发胸椎结核的疗效。方法自2003年1月～2007年4月对39例多发胸椎结核患者，术前正规抗结核治疗4—6周，侧前路彻底清除病灶，适当撑开矫正后凸畸形，行肋骨植骨侧前路单钉棒系统内固定，术后继续应用抗结核药物治疗1．5—2年。结果39例患者随访12—36个月，平均20个月。症状完全缓解24例，治愈率61．53％；部分改善11例，好转率28．21％，合计恢复率为89．74％。所有切口均为一期愈合，术后后凸畸形平均矫正25．2°,最终一次随访后凸角度平均矫正22．4°，后凸角度平均丢失2．8°；所有植骨均骨性融合。结论侧前路单钉棒系统内固定治疗多发胸椎结核，既能彻底清除病灶防止复发，又能矫正畸形、重建脊柱稳定性，防止晚发神经损害。

Objective To evaluate the effectiveness of the operation of latero-anterior internal fixation by one nail-stick system and rib graft for treatment of thoracic spinal tuberculosis. Methods Thirty nine patients with thoracic spinal tuberculosis were treated by the operation of one-stage latero-anterior debridement, spisnal cord decompression ,fib graft and internal fixation by one nail-stick system t from Jan 2003 to Apr 2007. All patients received anti-tubereolosis chemotherapy for 4 to 6 weeks before operation. 39 patients were constructed with rib graft and latero-anterior internal fixation by one nail-stick system. Anti-tuberculosis chemotherapy regularly was given for 1.5 - 2.0 years after surgery.Results All patients were followed-up for 12 - 36 months （average 20 nionths）Among 39 cases,24 were completely recovered （ cure rate 61.53 % ）, 11 were partly reeovered l cure rate 28.21% }, total recovery rate was 89.74%. All patients showed successful autograft bone graft fusion. The average immediate postoperative correction of kyphosis angle was 25.2°, the average correction of kyphosis angle at the time of last follow-up was 22.4°, the average loss of correction was orily 2.8°. Conclusion Operation of latero-anterior internal fixation by one nail-stick system and rib graft for treatment of thoracic spinal tuberculosis can cure tuberculosis without recurrence and can also correct deformity,strengthen the spinal structure to prevent secondary paraplegia.