摘要
内固定技术的应用是脊柱结核外科治疗的新发展,其目的是充分发挥内固定即刻重建脊柱稳定性的作用,促进局部结核控制和骨性融合达到结核病灶的静止与修复。临床实践证明在结核病灶局部植入组织相容性好、耐腐蚀性强的钛合金材料不会增加术后感染及结核扩散的发生率。内固定应用的适应证:①脊柱结核造成椎体破坏明显,在病灶清除或切除后必须用植骨来修复骨缺损及恢复椎间高度者;②病灶清除或切除后对脊柱的稳定性有明显损害者;③脊柱后凸畸形需矫正者。采用内固定时,须根据患者的具体病情,选择前路或后路内固定方法,采用Ⅰ期或Ⅱ期手术。应该明确,脊柱结核外科治疗只是辅助治疗方法,有效的抗结核化疗才是脊柱结核治疗的基础。
It was advancement for the treatment of spinal tuberculosis with internal instruments. The procedure could not only provide rigid fixation and good stability for early fusion, but also facilitate tuberculous rest and healing. It was not increase infection rate and diffusion to use instrument of good histocompatibility and corrosion-resistant titanium alloy. The indication of using internal fixation consists of three conditions as follows ： （1）Gross vertebral destruction and bone defect must be repaired with bone grafts to keep the vertebra sprung apart, after the diseased tissues, pus, sequestra, necrotic bone and devitalized disc were removed ;（2）The stabilization of the defective spine was lost by the debridement ;（3）Kyphotic deformity of the lesion needed to be corrected. It was selected using anterior or posterior surgical approach, and primary or secondary internal fixation according to the status of petient. Operative surgery was always accessory therapy, but efficient general anti-tuberculous measures is still of the utmost importance in treatment tuberculosis of spine.
出处
《中国骨伤》
CAS
2006年第8期507-509,共3页
China Journal of Orthopaedics and Traumatology
关键词
脊柱结核
外科手术
内固定
Spinal tuberculosis
Surgical procedures,operative
Internal fixators
