摘要
目的比较单纯自体植骨加钉棒系统内固定与钛网填充植骨加钉棒系统内固定治疗短节段腰椎结核的疗效。方法回顾性分析我院2006年1月至2009年9月收治的短节段(1～2个)腰椎结核患者42例,其中采用自体植骨加钉棒内固定23例(A组),同期采用钛网填充自体骨加钉棒系统内固定19例(B组),所有患者术前强化抗痨2周,术后规则抗痨治疗1年,两组患者术后均绝对卧床6周后在腰围的保护下逐渐起床活动。结果 所有患者随访6个月～3年,平均2年,无复发,手术切口均一期顺利愈合,两组患者术后JOA评分较术前有明显改善(P<0.001),两组间改善率无统计学意义(P>0.05),两组患者术后腰背痛的改善、神经损伤的修复、脊柱后凸畸形的手术矫正以及远期角度丢失及植骨融合情况,均无显著性差异(P>0.05),随访期间未见内固定及移植骨块松动、钛网明显塌陷及移位。结论 对于短节段(1～2个)椎体的腰椎椎体结核,一期病灶清除后,无论是采用单纯自体植骨加钉棒系统内固定还是采用钛网填充自体骨加钉棒系统内固定,两种治疗方法疗效无明显差异。
Objective To study the surgical effect of autologous bone graft vs. bone-filled titanium mesh cage graft in the treatment of sbort-segment lumbar spinal tuberculosis. Method Forty-two cases of lumbar spinal tuberculosis were treated between January 2006 to and September 2009. 23 of them were given an autologous bone graft plus a simple screw-rod fixation （group A） and the other 19 were treated with bone-filled titanium mesh graft plus a screw-rod fixation （ group B）. All the patients were subjected to 2-week pre-surgery intensive anti-tuberculosis medication , and this continued on a regular basis for 1 year post-surgery. After 6 weeks of being constrained to bed following the surgery, all the patients were gradually able to get up with the support of a waist protector. Result No recurrence happened during the follow-up period of 6 months to 3 years （ average 2 years）. All the incisions acquired satisfactory primary healing. A significant improvement for the JOA score was noted after surgery in both groups（ P 〈0.001 ）, while the difference between the two groups was not significant（P 〉0.05 ）. Further, the two groups did not exhibit much difference in the improvement of clinical symptoms, recovery of neurological function, surgery-reduced angles, bone fusion, and Cobb angles loss during the long-term follow-up. Neither internal fixation loosening nor obvious titanium mesh cage shifting and nor subsidence were noticed. Conclusion For short segment （ 1 or 2） lumbar spinal tuberculosis, treatments with bone graft and titanium mesh cage graft achieved similar and satisfactory results.
出处
《山东大学学报（医学版）》
CAS
北大核心
2011年第6期115-118,124,共5页
Journal of Shandong University:Health Sciences
关键词
椎体结核
自体植骨
钛网
内固定
Spinal tuberculosis
Autogcnous bone transplantation
Titanium mesh cage
Intcraal fixations
