椎弓根钉技术在胸腰椎结核治疗中的应用

APPLICATION OF PEDICLE SCREW TECHNIQUE IN THE TREATMENT OF SPINAL TUBERCULOSIS

目的探讨单纯应用椎弓根钉技术结合横突间或小关节突间植骨治疗胸腰椎结核的疗效。方法2007年7月．2013年2月赣州市第五人民医院（市传染病医院）治疗18例胸腰段脊柱结核患者。受累椎体均在2个或2个以下。且病灶相对局限，无大的流注脓肿。均采用单纯经后路椎弓根钉内固定、横突间或小关节突间植骨术式治疗。术后继续抗结核治疗12～18个月。结果随访9个月～5年观察效果,X线平片显示手术区植骨全部骨性融合，脊柱稳定。植骨融合时间为3-8个月，平均5个月。无结核复发。结论对于病灶较局限的胸腰段脊柱结核．采用单纯经后路椎弓根钉内固定、横突间或小关节突间植骨的手术方式能够维持手术后脊柱的稳定性，促进植骨融合、防止后凸畸形的发生。

Objective： To explore the effect of single application of pedicle screw technique combined with transverse or facet joint bone graft for the treatment of thoracic and lumbar tuberculosis. Methods： From July 2007 to February 2013, in Fifth People＇s Hospital of Ganzhou city （ city hospital for infectious diseases ）, there were 18 cases of thoracolumbar spinal tuberculosis patients. The involved vertebraes all were 2 or 2 below. And the focus was relatively limited, had no big streamer abscess. All were treated by posterior pedicle screw fixation, intertransverse process or facet spinal surgical treatment. Medical treatment for 12-18 months continued after operation. Results： Following up for 9 months to 5 years observation, X-ray plain film showed the bone bony fusion in grafting operation area and the stability of the spine. Bone graft fusion time was 3-8 months with the average of 5 months. There was no recurrence of tuberculosis. Conclusion： For thoracolumbar spinal tuberculosis lesions with limited focous. Treated by posterior pedicle screw fixation, intertransverse process or facet spinal operation method could maintain the stability of the spine postoperation, promote the fusion of bone graft, prevent kyphosis occurs.