经前路病灶清除一期植骨融合内固定治疗胸腰椎结核的效果观察

摘要

Objective To investigate technique and clinnical effect of the anterior approach of bone graft and internal fixation of 45patients from route for treatment of thoracolumber vertebra tuberculosis.Methods The clinnical data of 45 patients who had undergone the anterior approach of bone graft and internal fixation of route for treatment of thoracolumber vertebra tuberculosis from March 2008 to December 2012.To observe of postoperation tuberculosis toxic symtom ,the spinal stability improvement,the correction of kyphotic deformity and neurological improvement follow up the period.Results All patients were followed up for 9-10 months(average 18 months). The clinical and poisioning sympmtons were disappeard and internal fixation in good position. Cobb angle was corrected from preoperative 12.5°-38°(the average 24.5°), to one weeks postoperatively a10.5°, at three months11.5°(the average 14.5°).The recovery of spinal cord and neurological function in varying degrees.Conclusion The advantage of the anterior approach of bone graft and internal fixation of route for treatment of thoracolumber vertebra tuberculosis is the debridement thoroughly,the decompression results are better.It can effectively correct the deformity of spine,reconstruction of the stabilty of spine timely.It is the safe and effective method to treatment of thoracolumber spinal tuberculosis.%目的：观察经前路病灶清除一期植骨融合内固定治疗胸腰椎结核45例疗效。方法：回顾分析我院2008年3月-2012年12月前路病灶清除一期植骨融合内固定治疗胸腰椎结核45例患者，观察术后结核中毒症状的改善、脊柱稳定性情况、后凸畸形矫正情况、以及脊髓神经功能的回复情况。结果：所有病例均得到随访，随访时间9～24月，平均18月，临床及中毒症状消失、内固定良好、术前Cobb角12.5°～38°，平均24.5°，术后1周及3月平均10.5°及11.5°，平均矫正14.5°。脊髓神经功能均有不同程度的恢复。结论：经前路病灶清除一期植骨融合内固定治疗胸腰椎结核，病灶清除彻底、脊髓减压充分、可以有效的矫正脊柱畸形，及时重建脊柱的稳定性，是治疗脊柱胸腰段结核安全有效的方法。