脊柱结核的治疗.doc

一期病灶清除植骨内固定术治疗脊柱结核 厉晓龙， 　王生介，　刘俊，　 杨雷，　陆贝晨 （江苏大学附属常州武进人民医院骨科　213000） 关键词：脊柱结核；　病灶清除；　　内固定　　 One-stage debridement and intervertebral fusion with instrumentation in the treatment of spinal tuberculosis LI xiaolong, WANG shengjie, et al.Department of Orthopaedics, Changzhou, Wujin Hospital, Jiangsu University, Changzhou 213000, China Abstract: [object] To discuss the effectivity and safety in the treatment of spinal tuberculosis, explore the clinical significance with partial vertebretomy, grafting bone and internal fixation. [Methods] Data of 35 patients with spinal tuberculosis undergong the operation of debridement and grafting bone and anterior or posterior internal fixtion between January 2003 to January 2008 were documented retrospectively. 2 patients with cervical, 18 patients with thoracic and 15 patients with lumber spinal tuberculosis, 26 patients via anterior approach, 9 patients via posterior approach. All patients were followed up for 12～24 months, average 18 months. Results All these patients had their incision healed by first intention without sinus formation. Recurrence were found in 2 cases after first surgery in 3 months and performed second operation, the other’s toxic symptom of tuberculosis alleviated greatly, their focus was eliminated completely, no recurrence. Interbody fusion fused 5 months later, 12 cases with neurological deficits had an improvement of neurological function postoperatively, the technique Frankel average improve 1.5 grades, 15 cases with Kyphosis deformity was corrected mean 23? Conclusions One-stage debridement and grafting and anterior or posterior internal fixation with instrumentation in the treatment of spinal tuberculosis can reconstruct the spinal column stability, shorten the time lie in bed, correct and prevent Kyphosis deformity, the curative effect is accurate. Key words: spinal tuberculosis　　 debridement 　internal fixation　 脊柱结核是脊柱外科的常见疾病，其病程长，致残率高，对患者家庭和社会造成沉重的负担。近几年来，随着内固定技术和手术技巧的发展，我院骨科对脊柱结核患者采取一期前路病灶清除、植骨