前路病灶清除植骨融合内固定治疗颈椎结核

Anterior debridement and bone autograft fusion and instrumentation for cervical tuberculosis

目的探讨前路病灶清除植骨融合内固定治疗颈椎结核的临床疗效。方法采用前路病灶清除自体髂骨植骨融合内固定治疗18例颈椎结核患者。记录并发症情况。比较手术前后疼痛VAS评分、JOA评分。采用ECK融合分级标准评价植骨融合情况并观察颈椎融合节段高度。结果患者均获得随访,时间12~38个月。围手术期无食管损伤、深静脉血栓等严重并发症发生,随访期间均未发生钛板松动、断裂。末次随访时,颈椎融合节段高度较术后3 d无显著丢失(P>0.05),植骨均完全融合。VAS评分及JOA评分末次随访时均较术前明显改善,差异均有统计学意义(P<0.05)。结论前路病灶清除自体髂骨植骨融合内固定治疗颈椎结核可重建颈椎稳定性,临床疗效良好。

Objective To investigate the efficacy of anterior debridement,bone autograft fusion and instrumentation for cervical tuberculosis.Methods The 18 patients were treated with anterior debridement autogenous ililac bone graft fusion and instrumentation for treatment of cervical tuberculosis,the complications were recorded.The pain VAS and JOA score before and after operation were compared.Bone graft fusion condition was evaluated by ECK grading standard,and the height of cervical fusion segment was observed.Results All patients were followed up for 12~38 months.There were no serious complications such as esophageal injury and deep vein thrombosis.During the follow-up,there was no loosening or fracture of titanium plate.At the last follow-up,there was no obvious loss in the height of cervical fusion segment,compared with that measured at 3 d after operation(P>0.05),and all the grafts were completely fused.The VAS and JOA score were significantly improved at the last follow-up,with statistical differences(P<0.05).Conclusions The stability of cervical spine can be reconstructed by anterior debridement and autogenous iliac bone graft fusion and instrumentation,with good clinical effect.