摘要
[目的]评价一期前路经腹直肌旁腹膜后入路行病灶清除、自体髂骨植骨融合、后路椎弓根螺钉短节段固定融合治疗下腰椎单节段结核的手术疗效。[方法]2002年6月-2007年1月，本组采用该术式治疗下腰椎单节段结核27例。[结果]手术时间平均4．3h，手术平均出血量438ml。前路手术切口长度5—7cm，前路显露时间平均21min，显露过程平均出血量48ml。术后随访12～37个月，术前病变节段前凸角-2．1°±4．0°,术后4．9°±1．4°，最后随访时3．7°±3．0°。所有病例全部治愈，未发生结核复发，植骨融合率100％。[结论]前路经腹直肌旁腹膜后入路可满意显露病灶、操作简便、创伤小。后路椎弓根螺钉短节段固定融合使脊柱达到即刻稳定的同时减少正常运动节段的牺牲。该术式是治疗下腰椎结核安全、有效的方法。
[ Objective] To evaluate the clinical efficacy of posterior pedicle screw instrumentation followed by anterior debridement and bone grafting through the lateral edge of the rectus abdominal muscle and retroperitoneal approach for the treatment of tuberculosis of the lower lumbar spine. [ Methods] From June 2002 to January 2007, 27 patients suffering from lower lumbar tuberculosis were treated with this technique. [ Results] The surgical average time and amount of bleeding was 4. 3 h and 438 ml respectively. The length of anterior incision was 5 - 7 era. The average time and the amount of bleeding were 21 min and 48 ml respectively during the anterior lesion exposure. The follow- up period were 12 - 37 months, mean 17.3 months. The average preoperative, immediate postoperative, and final follow - up local lordotic angles of the affected segments were - 2. 1 ±4. 0°, 4. 9°±1.4°, 3.7° ± 3.0°. All patients had healed of disease and there was no recurrence at final follow up. Bony fusion was obtained in all patients. [ Conclusion] Anterior exposure through the lateral edge of the rectus abdominal muscle and retroperitoneal approach is simple and less invasive. The spinal stability is achieved through short - segment pedicle screw fixation while reducing the sacrifice of additional motion segments. This technique is safe and effective for the treatment of tuberculosis of the lower lumbar spine.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2010年第1期13-16,共4页
Orthopedic Journal of China
关键词
腰椎
结核
病灶清除术
椎弓根螺钉
手术入路
lumbar
tuberculosis
debridement
pedicle screw instrumentation
surgical approach
