经侧前方入路一期植骨内固定治疗胸腰椎结核

The Anterior Side of A Bone Graft and Internal Fixation for the Thoracolumbar Spinal Tuberculosis

目的：探讨经侧前方入路一期植骨内固定治疗胸腰椎结核的临床疗效。方法：对16例胸腰椎结核患者严格正规抗痨治疗4周,患者中毒症状改善后,行前路病灶清除一期植骨融合内固定手术,术后常规抗痨治疗9~12月,观察术后症状改善、神经损害恢复、脊柱后凸矫正、植骨融合情况。结果：所有患者术后均获得随访,随访时间为10~48个月,平均31.2个月。术后全身症状及局部疼痛消失;神经症状有不同程度恢复,后突畸形明显矫正,植骨融合时间3~6个月,平均4个月。随访期间未出现明显内固定松动,未见结核复发。结论：对胸腰椎结核患者行前路病灶清除一期椎间植骨内固定治疗可明显缓解患者症状,改善生活质量,有效矫正脊柱后凸畸形,重建脊柱稳定性,获得良好的骨性融合,达到良好的临床效果。

Objective：To analysis clinical efficacy of the anterior side of a bone graft and internal fixation for the thoracolumbar spinal tuberculosis.Methods：16 cases of thoracolumbar spinal tuberculosis patients by strict formal anti-tuberculosis treatment for 4 weeks,after symptoms improved,anterior debridement and a fusion fixation surgery were done in patients,conventional anti-tuberculos was treated from September to December,observed symptoms improved,nerve damage restoration,kyphosis correction,fusion situation after surgery.Results：All patients were followed up from 10~48 months,with an average of 31.2 months.Postoperative Systemic symptoms and local pain disappeared;neurological symptoms had different degrees of recovery,after the sudden deformity corrected,and fusion for 3 to 6 months,an average of 4 months.During follow-up,no obvious fixation loosening,and no recurrence of tuberculosis.Conclusion：Anterior debridement and an interbody fixation for thoracolumbar spinal tuberculosis in patients can get an significantly relieve symptoms,improve quality of life,effective correction of kyphosis,reconstruct spinal stability,access to good bone fusion,to achieve a good clinical effects.