经前路病灶清除加自体髂骨植骨、内固定治疗胸腰椎结核疗效观察

Debridement and Self Iliac Bone Graft Via Anterior Approach Spinal Thoracolumbar Tuberculosis Treatment of Internal Fixation

目的:探讨经前路病灶清除加自体髂骨植骨、内固定治疗脊柱胸腰椎结核的临床疗效。方法:将84例患者随机分为观察组(44例)和对照组(40例),观察组采用病灶清除植骨内固定术治疗,对照组采用病灶清除术治疗,比较两组的临床治疗效果。结果:84例患者均得到随访,最短1年2个月,最长随访6年,平均43.5月。观察患者均达到临床愈合,随访期内未见复发病例,脊柱后凸畸形改善,无明显并发症发生;对照组有7例患者局部复发需要再次手术治疗;观察组疗效显著优于对照组(P【0.05)。结论:经前路病灶清除自体髂骨植骨内固定治疗胸腰椎脊柱结核疗效确切。

Objective:To investigate the efficacy of anterior interbody fusion and anterior internal fixation in surgical management in thoraco lumbar spinal tuberculosis.Methods:84 patients of fungus infection of lung were divided randomly into the intervention group(44 cases) and the control group(40 cases),the patients of intervention group were treated with extraperitoneal nidus debridement interbody fusion with iliac bone graft,internal fixation with vertebral nail and steel plate,the patients of control group were treated with radical focus debrided or anterior iliac bone transplantation,and then compared the effect of them.Results:The follow up involved with an average time of 43.5(14～72) months.The patients of intervention group attained clinical healing,no recrudescence occurred in the followup time,the kyphosis deformity was improved without associated complication;7 patients of control group were needed another operations because of the reccurrence of tuberculosis,which showed that the former were better than the latter(P<0.05).Conclusion:It is definite that thoracolumbar tuberculosis were treated with anterior nidus debridement with internal fixation and autologous iliac bone graft.