硬化骨均匀钻孔联合同种异体髂骨块治疗腰椎结核的临床应用

Treating patients with lumbar tuberculosis by keeping sclerotic bone uniformly drilled joint with implanting allograft iliac bone for inter body fusion

目的探讨硬化骨均匀钻孔联合同种异体髂骨块治疗腰椎结核的临床应用价值。方法回顾性分析行硬化骨均匀钻孔联合同种异体髂骨块手术治疗的47例腰椎结核患者的临床资料。结果术后随访16~24个月,47例患者结核全部治愈。椎间植骨块融合时间6~12个月,按骨融合标准优37例,良8例,可2例,差0例。脊柱后凸畸形25例,术后2周、末次随访时Cobb角低于术前,差异有统计学意义（P〈0.01）。患者神经功能均有不同程度的恢复。Frankel分级：1例A级恢复至C级;2例C级患者中1例恢复至E级,1例恢复至D级;3例D级患者全部恢复至E级。结论硬化骨均匀钻孔联合同种异体髂骨块前路一期内固定术治疗腰椎结核,临床疗效肯定,术后恢复好,是治疗腰椎结核的有效方法,值得临床推广应用。

Objective To investigate the value of treating patients with lumbar tuberculosis by keeping sclerotic bone uniformly drilled joint with implanting allograft iliac bone for inter body fusion.Methods There were 47 patients with lumbar tuberculosis in this retrospective study who were treated by surgery of keeping sclerotic bone uniformly drilled joint with implanting allograft iliac bone for inter body fusion.Results Postoperative follow-up were 16-24 months.Forty-seven patients with lumbar tuberculosis were all cured.The bony fusion time of 47 patients was 6months to 12 months.In accordance with the standard of bone fusion,the results were excellent in 37 cases,good in 8cases,fair in 2cases,and poor in 0case.Kyphosis in 25 cases with Cobb angle have been found,2weeks after the surgery and the final follow-up,the kyphotic deformity were corrected,and the difference was statistically significant（P〈0.01）.The patients′neurological functions were elevated in varying degrees.The Frankel grading showed that：1case was recovered from grade A to grade C,1case was recovered from grade C to grade E,1case was recovered from grade C to grade D,and 3cases were recovered from grade D to grade E.Conclusion Good surgical outcomes have been found in this study and the technique that treating patients with lumbar tuberculosis by keeping sclerotic bone uniformly drilled joint with implanting allograft iliac bone for inter body fusion could be applied further in the clinical trial.