脊柱结核外科治疗骨缺损的修复

Bone defect repair in the surgical treatment of spinal tuberculosis

背景:脊柱结核外科干预治疗中如何有效修复破坏之椎体,是脊柱结核治疗中的重点和难点。目的:探讨国内目前脊柱结核病灶清除后骨缺损修复方法、骨缺损修复的有效方法及新进展。方法:CNKI数据库检索2006/2010-01-01五年间相关脊柱结核外科治疗文献,先检索关键词"脊柱结核",再分别以:"内固定","植骨","人工骨(材料)","钛网","骨水泥","人工椎体",为关键词在以上数据中检索,根据入选条件,选择相关文献,对其文献报道病例、手术方法(包括骨修复方法)、疗效(包括治愈率、复发率、Cobb角纠正)进行统计分析。结果与结论:自体骨(髂骨、肋骨)是脊柱结核目前骨缺损的主要修复来源,其次是钛网植骨,人工骨及人工椎体少量用于临床治疗。提示,自体骨仍是脊柱结核骨缺损修复的主要来源,是钛网植骨次之,人工骨及人工椎体有广阔的发展空间,成为将来植骨理想替代品。

BACKGROUND：How to repair damage to the vertebral body using surgical methods is important and difficult for treatment of spinal tuberculosis OBJECTIVE：To learn a variety of the methods to repair bone defects in spinal tuberculosis after lesions removal in China at present,and to find out the effective methods and new progress. METHODS：CNKI database was search for the literature related to surgical treatment of spinal tuberculosis published 2006/2010-01-01. First,the of ＂spinal tuberculosis＂ was used and then ＂internal fixation＂,＂bone graft＂,＂synthetic bone（materials） ＂,＂titanium mesh＂,＂bone cement＂,＂artificial vertebral body＂ were used as key words in the above data retrieval. According to selected conditions,the relevant literature with reported cases,surgical procedures（including bone repair method） ,effects（including cure rate,relapse rate,Cobb angle corrected） were selected for statistical analysis. RESULTS AND CONCLUSION：Autologous bone（iliac,ribs） is the major source of repaired bone defects in spinal tuberculosis,followed by titanium mesh and bone graft,and a small amount of synthetic bone and artificial vertebral body is used for clinical treatment. In the future,synthetic bone and the artificial vertebral body have a broad development space,being an ideal substitute.