一期前路病灶清除植骨融合钛板固定治疗颈椎结核

One-stage Surgical Treatment of Cervical Spinal Tuberculosis ment, Iiiac Grafting and Internal Fixation

【目的】评价一期前路病灶清除植骨融合钛板固定在治疗颈椎结核中的临床疗效。【方法】2004年2月至2008年2月对32例颈椎结核患者采用一期前路病灶清除，植骨融合钛板固定术，术前2～3周抗痨、术后正规抗痨治疗9～12个月。术后随访时间14个月至3年，平均时间为19个月，回顾分析手术适应证，术后症状改善、远期疗效及并发症情况。【结果】所有患者疼痛症状均消除，无一例出现感染和复发，结核治愈率为100％；术后6个月时骨性融合率达50％，12个月时达100％，椎体高度恢复1．1～2．1cm，平均1．4cm，cobb＇s角平均纠正20°。【结论】一期前路病灶清除植骨融合钛板固定治疗颈椎结核具有减压彻底、神经功能恢复良好、重建可靠和复发率低等优点。

[Objective]To evaluate the efficacy of anterior radical debridement, iliac grafting and internal fixation for treating cervical spinal tuberculosis. [Methods] From Feb. 2004 to Feb. 2008, 32 patients were operated with anterior radical debridement, iliac grafting and internal fixation. These patients carried out regular anti-tuberculosis plan both before and after operations. During the follow-up from 14 to 36 months （an average of 19 months）, complication and neurological function were assessed. [Results] All patients had no painful symptoms. Recurrence and affection were not found in all patients, and the cure rate was 100%. The bone fusion rate at 6 and 12 months after operation was 50% and 100%, respectively. The height of the verte brae recovered was from 2. lcm to 2. 1cm with an average of 1.4cm, and the cobb＇s angle corrected was 20°at average. [Conclusion]One-stage surgical operation with anterior radical debridement, iliac grafting and inter nal fixation is an effective for the treatment of fervical spinal tuberculosis. It has advantages of complete decompression, good neurological function recovery, stable reconstruction and low recurrence rate, etc.