异体腓骨环椎间融合器-第三军医大学学报.DOC

异体腓骨环支撑植骨治疗单间隙腰椎结核的临床疗效观察 郭从涛，蒲小兵，周 强，代 飞，张劲松，罗 飞，张泽华，许建中 (第三军医大学西南医院骨科,全军矫形外科中心，重庆 400038) 摘 要：目的 探讨异体腓骨环（Allogeneic Fibula Ring，AFR）结合后路椎弓根钉内固定，行腰椎结核手术治疗的临床疗效。方法 回顾性总结自2005年1月-2008年1月间收治的单节段腰椎结核，需行病灶清除、椎间植骨融合的22例患者，其均行彻底结核病灶清除、异体腓骨移植、后路椎弓根钉加压内固定，术前、术后均采用18个月标准化疗方案（3SHRZ/15HRZ），术后佩戴腰背支具3～6个月，通过术前、术后3、6、12、24个月定期随访，复查腰椎CR、CT或MRI片，评价手术治疗效果。结果 随访18～52个月，平均34.8个月。所有患者无腰椎结核复发、无椎间隙高度降低；术后6个月融合率为100%。结论 AFR支撑植骨，能有效地恢复椎间隙高度及防止椎间隙高度下沉，结合后路椎弓根加压内固定，为骨性融合提供较好的稳定环境，有效地提高了融合率和治愈率，取得了满意的治疗效果。术前、术后规范用药、加强营养支持，术中彻底结核病灶清除、AFR支撑植骨、后路椎弓根钉加压内固定是治疗单间隙腰椎结核的有效手术方法。 关键词：异体腓骨环；椎弓根钉加压内固定；腰椎结核 中图法分类号： 文献标识码；A The observation of clinical efficacy of central support allograft fibula ring bone graft in the treatment of single-space spinal tuberculosis GUO cong-tao，PU xiao-bing，ZHOU qiang，DAI fei，ZHANG jin-song，LUO fei，ZHANG ze-hua，XU jian-zhong(Department of Orthopedics，Southwest Hospital，Third Military Medical University，Chongqing400038，China) Abstract: Objective Discuss Allogeneic Fibula Ring (Allogeneic Fibula Ring, AFR) pounds vertebral arch root nail inner fixation combining with a route of retreat, line the clinical curative effect that lumbar vertebra tuberculosis operation cures. Methods Retrospect recollect nature summing up the Shan Jie Duan lumbar vertebra tuberculosis in January , 2005-January , 2008 , need line nidus clears away , the vertebra inter-planting bone fuses 22 example patients, whose equal thorough line tuberculosis cooking stove clears away , allosome fibulare transplanting , the route of retreat fix within vertebra vertebral arch root nail compression, the skill queen adopt 18 moon standard chemotherapy scheme (3 SHRZ/15HRZ) without exception in the skill front, the skill queen wears middle back branch utensil 3-6 months , for 24 months is periodical before passing a skill , last 3 , 6 , 12 the skill, follow-up, Reexamine lumbar vertebra CR , CT or MRI movie , estimate that operation cures effect.Resul