钛网支撑植骨融合加前路钉棒系统内固定治疗胸腰椎结核.docVIP

钛网支撑植骨融合加前路钉棒系统内固定治疗胸腰椎结核【摘要】 目的 探讨一期前路病灶清除钛网支撑植骨融合加内固定治疗胸腰椎结核的临床疗效。方法 回顾性分析2001年2月至2008年3月在本院接受治疗的胸腰椎结核患者21例，男12例，女9例，年龄18~72岁，平均48.5岁。所有患者均采用一期前路病灶清除、钛网支撑植骨融合加前路内固定术，其间观察围手术期并发症，测定融合节段后突角度、椎间平均高度、钛网沉降率及植骨融合情况。结果 全部病例随访20~48个月，平均26个月，除1例出现肋间神经痛，其余20例均无术后并发症。随访期间未发现结核病灶残留或复发，术后融合节段后凸角为（7.0±2.5）°，终末随访时矫正角度丢失（4.1±1.5）°，所有患者终末随访均达到骨性愈合。结论 一期前路病灶清除钛网支撑植骨融合加内固定治疗胸腰椎结核的临床疗效显著，具有重建可靠，减压彻底和复发率低等优点。 【关键词】 胸腰椎结核；病灶清除；钛网植骨；钉棒系统内固定 Operation of latero-anterior internal fixation by nail-stick and titanium mesh and bone graft for treatment of thoracolumbar spinal tuberculosis LIU Ya,WANG Zong-liang,CAI Ming,et al.Nanyang City Orthopedic Hospital,Henan 473000,China 【Abstract】 Objective To evaluate the clinical value of the one-stage anterior radical debridement,titanium mesh cages(TMCS) bone fusion and internal fixation for the treatment of thoracolumbar spinal tuberculosis.Methods Twenty-one thoracolumbar spinal tuberculosis cases from February 2001 to March 2008 were analyzed retrospectively,There were 12 males and 9 females,and mean age was 48.5 years old(18 to 72 years old),operative methods including anterior radical debridement、bone fusion with titanium mesh cages combined anterior internal fixation were performed.During this period perioperative complications were observed.Degree of byphosis、intervertebral averaging height、bone fusion and TMCS subsidence pre and postoperatively were determined.Results All the patients were followed up for 20 to 48 months postopratively,with the average of 26 months.In addition to the emergence of 1 cage of intercostals neuralgia,the remaining 20 patients had no postoperative complications.During the follow-up found no residual or recurrent lesions of tuberculosis.The postoperative kyphosis angle was (7.0±2.5)°,the loss angle of kyphosis correction was(4.1±1.5)°,All patients reached the end follow-up bone healing.Conclusion The significant curative effect of one-stage anterior radical debridement,titanium mesh cages bone fusion a