经前路病灶清除钉棒内固定治疗儿童脊柱结核11例

Debridement of lesion and screw-rod fixation via anterior approach in the treatment of children with spinal tuberculosis

目的探讨经前路病灶清除钉棒内固定治疗儿童脊柱结核的临床疗效。方法我院2001年2月至2005年5月采用经前路病灶清除钉棒内固定术治疗儿童脊柱结核11例,手术前后均行正规化疗,术后平均随访1年半(18个月)。观察术前、术后的临床症状、病灶情况、影像学改变、术后并发症等。结果术后均获随访,随访时间12-23个月,平均18个月。全部病例伤口均一期愈合,术前症状消失或不同程度缓解,后凸畸形明显改善,未出现严重并发症。植骨融合时间平均6个月,后凸平均矫正度数为11°±3°,2例术前伴有神经损害症状者Frankel分级平均提高2级。结论经前路病灶清除钉棒内固定术能较好清除病灶,矫正脊柱的后凸畸形,重建脊柱的稳定性,是治疗儿童脊柱结核的有效方法,近期随访手术结果满意,远期疗效需进一步观察。

Objective To study the clinical efficacy of the debridement of lesion and screw-rod fixation via anterior approach in the treatment of children with spinal tuberculosis.Methods From February 2001 to May 2005,11 patients with spinal tuberculosis were treated with the debridement of lesion and screw-rod fixation via anterior approach,chemotherapy before and after the regular line,and followed up for an average of 18 months. Preoperative and postoperative clinical symptoms and lesions,the image changes,such as post-operative complications were observed.Results The wounds of all patients were cured,and preoperative symptoms disappeared or alleviated. Kyphosis was corrected with no serious complications,and the average degree of correction was 11°±3°. The average fusion time was 6 months.Conclusion The debridement of lesion and screw-rod fixation via anterior approach can remove lesions,correct kyphosis of the spine and reconstruct spinal stability,and hence it is an effective way to treat spinal tuberculosis in children.