后路病灶清除植骨联合骶髂单钉棒固定治疗骶髂关节结核19例

Cases of Bone Grafting with Posterior Focus Debridement Combining Single Rod-screw Fixation of the Sacroiliac Joint in the Treatment of Sacroiliac Joint Tuberculosis

目的探讨后路单钉棒固定在骶髂关节结核治疗中应用的价值。方法 2010年至2015年我院收治骶髂关节结核患者19例,经术前骨盆X片、骨盆CT及三维重建、实验室检查及穿刺活检,明确诊断为骶髂关节结核。采用病灶清除结合骶1椎弓根-髂骨螺钉单钉棒固定、骶髂关节植骨融合术对该组患者进行手术治疗,术后常规抗结核治疗12~18个月。结果所有患者均获得随访,随访时间12~33个月,平均随访时间15.4个月,骶髂关节结核均获治愈。所有病例均获得骨性融合,无内固定松动、断裂。结论后路病灶清除、植骨融合联合骶髂单钉棒固定具有操作简单、早期稳定骨盆的作用,是治疗骶髂关节结核的一种有效方法。

Objective To discuss the value of posterior single rod-screw fixation in treatment of sacroiliac joint tuberculo- sis. Methods From 2010 to 2015,19 patients with sacroiliac joint tuberculosis hospitalized in our hospital ,who had definite diag- nosis of sacroiliac joint tuberculosis by preoperative pelvic X-ray, pelvic CT and 3-D reconstruction, laboratory examination and needle biopsy. The surgical treatment of focus debridement combining single rod-screw fixation in S-1 pedicle bone and iliac bone, and bone graft fusion of sacroiliac joint was performed on this group of patients, and routine postoperative anti-tubercular therapy was provided for 12 to 18 months. Results All patients were followed up for a duration of 12 to 33 months and an average duration of 15.4 months ,which showed that all cases of sacroiliac joint tuberculosis were cured. Bony fusion was obtained in all the pa- tients, with no screw loosening or breaking in the internal fixation. Conclusion Posterior focus debridement and bone graft fusion combining single rod-screw fixation of the sacroiliac joint is simple and can stabilize pelvis on early stage, which is an effective method for treatment of sacroiliac joint tuberculosis.