带血管蒂肋骨瓣植骨融合治疗胸腰椎化脓性椎间隙感染

TREATMENT OF THE PYOGENIC INFECTION OF THE THORACOLUMBAR INTERVERTEBRAL SPACE WITH VASCULAR PEDICLED RIB GRAFTING

目的 观察带血管蒂肋骨瓣植骨融合治疗胸腰椎化脓性椎间隙感染的结果。方法 1993年 11月以来 ,对 7例胸腰椎化脓性椎间隙感染经骶棘肌、腰方肌间隙行彻底病灶清除 ,同一切口内切取带血管蒂肋骨瓣椎体间植骨融合。结果 术后 7例获 10个月～ 5年随访 ,平均随访 2年 4个月 ,椎体间骨愈合时间 3个月 5例 ,4个月 2例 ,无一例病灶复发及脊柱后凸畸形。结论 经骶棘肌腰方肌间隙病灶清除彻底 ,采用带血管蒂肋骨瓣椎体间植骨手术操作简便 ,缩短了骨愈合时间 。

Objective To investigate the effect of vascular pedicled rib grafting in treatment of the pyogenic infection of the thoracolumbar intervertebral space. Methods From November 1993, 7 cases with pyogenic infection of the thoracolumbar intervertebral space were adopted in this study. Among them, there were 5 males and 2 females, aged from 29 to 58 years old. The position of pyogenic infection located at T10 to 11 in 3 cases, at T11 to 12 in 2 cases and at T12 to L1 in 2 cases. During operation, the pyogenic infection was cleared completely and the rib with vascular pedicle was grafted into the intervertebral space. Results Followed up for 10 to 60 months, the bone graft unioned in 3 months for 5 patients and unioned in 4 months for 2 patients. There was no recurrence and raised kyphosis. Conclusion The technique of vascular pedicled rib graft is simple, it can shorten the bone union time and reconstruct the stability of spine.