脊柱结核外科治疗的临床研究

Clinical Research of Spinal Tuberculosis Surgical Treatment

目的研究脊柱结核行Ⅰ期病灶清除、脊髓减压、植骨融合内固定术等外科治疗配合抗结核药治疗的效果。方法选取山东省菏泽市传染病医院自2007年1月至2010年10月脊柱结核患者50例,手术前后均积极对症处理和应用抗结核药物治疗,采用Ⅰ期病灶清除、脊髓减压、植骨融合内固定术,术后定期复查。结果所有患者无严重并发症发生,切口均Ⅰ期愈合。术后随访发现患者植骨均骨性融合,骨畸形获得矫正平均Cobb角5.5°～14°,平均9.5°,神经功能分级为:B级2例,C级4例,D级9例,E级35例。结论脊柱结核采用综合治疗手段,外科手术配合积极内科抗结核治疗能够获得良好疗效,明显改善患者症状,提高生活质量。

Objective To studyⅠperiod lesions do spinal tuberculosis removal,spinal cord decompression,such as bone graft fusion fixation with surgical treatment effect of anti-tuberculosis medication. Methods Select Heze Hospital for Infectious Diseases all January 2007~2010 October spinal tuberculosis patients before and after surgery 50 cases, are actively received alimta and application anti-tuberculosis medication, Ⅰ period by clear, spinal cord lesions bone graft decompression,fusion fixation,postoperative check regularly.Results All patients with no major complications, incision Ⅰ period were healed. Follow-up of patients with osteoarthritis found both bone graft, bone deformities gain correction fusion Cobb Angle 5.5 ° - average °, on average, 14 °, neurological classification 9.5 for： B level 2 cases,C level 4 cases,D level 9 cases,grade E 35 patients.Conclusion Spinal tuberculosis using the integrated treatment, surgical cooperate actively medical antitubercular treatment can obtain good curative effect, significantly improve patients with symptoms, improve the quality of life.