前路病灶清除植骨内固定术治疗腰段脊柱结核的临床分析

Anterior Radical Debridement with Autograft Bone Fusion and Internal Fixation in Treating Spinal Tuberculosis in the Lumbar Segment

目的评价经前路病灶清除植骨融合内固定术治疗腰段脊柱结核的临床效果。方法手术治疗腰段脊柱结核56例,采用前路病灶清除植骨融合内固定术。术后常规短程化疗,定期复查,检测X片及血沉。结果 51例患者获得随访,随访时间18~36个月（平均30个月）,1例于术后4周再次出现窦道,重新行手术清除病灶。余经定期X线摄片复查证实植骨块均在术后6~8个月融合,未见植骨块松动移位,局部无复发,患者弯腰和下蹲活动无受限。结论前路病灶清除植骨融合内固定术治疗腰段脊柱结核,能提高植骨融合率,缩短卧床时间,降低复发率低。

Objective To evaluate the clinical efficacy of anterior radical debridement with autograft bone fusion and internal fixation in treating spinal tuberculosis in the lumbar segment.Methods Fifty-six patients with spinal tuberculosis were treated with anterior radical debridement with autograft bone fusion and internal fixation,followed by routine short-term anti-tuberculosis chemotherapy.All patients underwent by X-ray and ESR examination postoperatively.Results Fifty-one patients were followed-up for 18-36 months with an average duration of 30 months.One case showed a sinus about 4 weeks after operation and received a second operation.Other patients showed no complications.X-ray examination showed that grafted bones in all cases fused in 6 to 8 months and no loosened or dislocated bone grafts were noticed.No recurrence of spinal tuberculosis were found.No restriction was complained by the patients during bending and squating.Conclusion Anterior radical debridement with autograft bone fusion and internal fixation is an effective method to treat spinal tuberculosis in the lumbar segment,with increased fusing rate of grafted bones and reduced recurrence of tuberculosis.