摘要
目的：评价内固定在脊柱结核治疗中的应用价值。方法：2001～2003年采用侧前方手术病灶清除加内固定系统治疗胸、腰椎脊柱结核患者16例,其中后路病灶外内固定12例(TSRH钉棒横桥系统5例,TSRH钩棒横桥系统7例),前路病灶野内Z-Plate钉板内固定系统4例,椎体间皆采用自体植骨融合。所有患者均采用标准化疗方案。术后随访18～24个月(平均20个月)。结果：16例患者切口均Ⅱ—甲愈合,1例并发单侧胸膜外后方脊旁积液(自愈),无结核病灶复发,椎体间植骨均获融合,无内固定失败。有脊髓压迫表现者,Frankel评分均获提升。结论：传统脊柱结核手术与内固定系统结合应用具有病灶清除彻底、固定坚强、能矫正畸形、融合率高、减少卧床时间、安全的早期功能锻炼、总体医疗费用降低以及后期并发症低等优点,而复发率保持不变,具有很高的临床应用价值。
Objective：To evaluate the clinical efficacy of internal fixation in the treatment of spinal tuberculosis. Methods： 16 patients with thoracic, thoracolumber spinal tuberculosis were treated surgically by internal fixation from June 2001 to June 2003, including posterior out-of-focus instrumentation in 12 cases （5 cases with TSRH pedicle screw-stick-bridge system, 7 cases with TSRH hook-stick-bridge system）, and anterior in-focus instrumentation in 4 cases with Z-plate system. All the cases used bony autografting. All the patients were followed up 18～24 months after surgery（20 months on average）. Results：16 cases had their incision healed by first intention and only one occurred single pleural effusion beside spine but soon healed. No recurrence of spinal tuberculosis was noted during the follow-up period. Spinal solid fusion at the interface between the graft and adjacent vertebral bodies was shown radiologically. No internal fixation failed. The Frankel grade of those who had signs of spinal pressed was raised. Conclusion： Internal fixation with traditional surgery in spinal tuberculosis is the best surgical treatment for spinal tuberculosis. It has such advantages as rigid and stabilized fixation, less time in bed, safe and early function-exercise, high rate of spinal solid fusion, less fee of healing and its rate of recurrence has no change, which has very high value in clinical medicine.
出处
《中国临床医学》
北大核心
2006年第3期473-475,共3页
Chinese Journal of Clinical Medicine
关键词
脊柱结核
内固定
外科手术
Spinal tuberculosis
Internal fixation
Surgery
