一期后路病灶清除、椎体间植骨融合内固定治疗腰骶段脊柱结核疗效.docVIP

一期后路病灶清除、椎体间植骨融合内固定治疗腰骶段脊柱结核疗效【摘要】 目的 探讨一期后路病灶清除、椎体间植骨融合内固定治疗腰骶段脊柱结核的临床疗效。方法 对16例腰骶段脊柱结核患者采取一期后路病灶清除、椎体间植骨融合内固定术。男5例，女11例，年龄20~56岁，平均38岁。病变累及L4/5者7例，L5/S1者9例。手术前、后检查红细胞沉降率， X线片上测量腰骶角、椎间隙高度评估结核活动、植骨融合和畸形矫正情况。术前腰骶角平均18.6°；椎间隙高度平均7.9 mm。结果 手术时间平均180 min，术中出血平均475 ml。术中无主要血管、神经损伤及严重并发症发生。本组优14例，良2例，优良率为100%，16例植骨全部确定融合。术后腰骶角平均27.1°；末次随访平均25.9°。术后椎间隙高度平均10.6 mm，与术前比较平均撑开高度2.7 mm，末次随访时平均10.4 mm，丢失小于1.0 mm。术前与术后及末次随访结果比较差异具有统计学意义（P＜0．05）。随访平均30个月，无结核病变复发、内固定松动、断裂及明显矫正度丢失等严重并发症发生。结论 对腰骶段脊柱结核的患者采取一期后路病灶清除、椎体间植骨融合内固定手术是一较为有效、可行的方法。? 【关键词】腰骶段；脊柱结核；后路手术；内固定 ?? One-stage posterior radical eradication、bone graft fusion and instrumentation in treating of the lumbosacral tuberculosis Turghunjan#8226;Abdurxit，SHENG Wei-bin et al. Department of Spine Surgery, Sixth Infirmary Hospital of Xinjiang Medical University，Urumqi830002,China ? 【Abstract】 Objective To investigate clinical indications of one-stage posterior radical eradication, bone graft fusion and instrumentation in treatment of the lumbosacral tuberculosis.Methods Sixteen cases with tuberculosis of the lumbosacral spine were treated by one-stage posterior radical eradication, bone graft fusion and instrumentation fixation. All patients included 5 males and 11 females, and the average age was 38 years ( range 20~56 years ). The affection segment of L4/5 was seven and L5/S1 was nine. ESR(erythrocyte sedimentation rate)，Roentgenogram of the lumbosacral angle and intervertebral space altitude were concerned to estimate the progress of the tuberculosis activity, bone graft fusion and states of the deformity correction between the preoperative and postoperative. The average lumbosacral angle of the preoperative was 18.6°, the average intervertebral space altitude of the preoperative was 7.9 mm.Results The average operation time was 180 min. The average blood loss during the operation was 475 ml. There were not the main vessel and nerve injury and serious complications in the operation. In this study, fourteen