前路Ⅰ期病灶清除、植骨、内固定治疗脊柱结核(附37例报告)

Anterior Debridement,Interbody Allografts and Internal Fixation for the Treatment of Spinal Tuberculosis in One Stage

观察前路Ⅰ期病灶清除、植骨、内固定治疗脊柱结核的疗效。方法 :1996年 1月～ 2 0 0 2年 12月间采用该手术方法共治疗脊柱结核 37例。其中 :颈椎 3例 ,胸椎 5例 ,胸腰椎 17例 ,腰椎 12例 ;3例伴窦道形成 ;9例伴不同程度的脊髓和 (或 )神经根受压的症状 ;术前后凸成角 10°～ 72° ,平均 31°。结果 :平均随访 1.7年 ,优良率为 90 %,植骨融合率可达 95 %,后凸矫正角度 13°,术后无一例复发。结论 :前路彻底病灶清除、植骨、内固定治疗脊柱结核病灶清除彻底 ,有利于恢复脊柱的稳定性 ,提高骨融合率 ,可纠正及预防脊柱后凸畸形。

Objective:To evaluate anterior debridement,allografts and internal fixation for the treatment of spinal tuberculosis in one stage.Methods:37 cases of the spinal tuberculosis were treated with anterior debridement,allografts and internal fixation.The involved spine was at cervical spine in 3 patients,at thoracic spine in 5 patients,at thoracolumbar spine in 17 patients and at lumbar spine in 12 patients.sinus were associated in 3 patients and 9 patients had neurologic dificites.The preoperative kyphosis was 10～72 degrees with mean of 31 degrees.Results:The average followed-up period was 1.7 years.90 % of the patients had good results and 95 % had solid body fusion.13 degrees of kyphosis correction was achieved and there were no cases of recurrence.Conclusion:Spinal tuberculosis treated with this surgical technique can achieve a high satisfactory rate with restoring the spinal stability,providing early fusion,correcting and preventing progression of the kyphosis.