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1、180职业卫生与病伤2006年第21卷第3期JournalofOccupationalHealthandDamage20061Vol121No13【论著】前路病灶清除一期植骨内固定治疗胸腰椎结核1122233戢良超,伍万清,胡豇,刘仲前,王跃,卢波,吴林[摘要]目的探讨前路病灶清除,一期植骨钛钢板内固定治疗胸腰椎结核的疗效。方法2000-05/2005-06采用前路病灶清除,一期植骨钛钢板内固定治疗胸腰椎结核52例。男32例,女20例,年龄21～65岁,平均38岁。影像学显示单椎体破坏塌陷9例,双椎体破坏塌陷楔形变43例,脊柱后凸畸形35例,cobb’s角14～41°,平均24°。不全截瘫19
2、例。血沉40～110mm/h。术前抗结核药物治疗2～4周。术后继续抗结核药物治疗10～12个月。结果切口均一期愈合,随访112～4年,平均212年。植骨块6～7月融合,无移位,折断和吸收。19例不全截瘫者术后2～4月恢复到E级。35例脊柱后凸角度平均矫正14°。血沉于术后3～5月恢复到正常。随访期内结核病灶无复发。结论前路病灶清除、一期髂骨植骨钛钢板内固定是治疗脊柱结核较安全有效的治疗方法。[关键词]胸腰椎结核;前路手术;髂骨植骨;内固定[中图分类号]R521[文献标识码]A[文章编号]1006-172X(2006)03-180-03TreatmentofThoracolumbarSpinal
3、TuberculosiswithAnteriorRadicalDebridement,IliacGraftingandInternalFixationJILiang-chao,WUWan-qing,HUJiang,etal.DepartmentofOrthopedics,PeoplepsHospitalofPengshanCity,Pengshan620800,China.AbstractObjectiveTodiscusstheclinicalefficacyintreatingthethoracolumbarspinaltuberculosiswithradicaldebridement,
4、iliacgraftingandinternalfixation.Methods52patientswiththoracolumbarspinaltuberculosisweretreatedbyanteriorradicaldebridementofthediseasedvertebrae,iliacgraftingandinter2nalfixationfromMay2000toJun.2005.Therewere32malesand20femalesandmeanagewas38yearsold(21～65yearsold).35patientshadspinalkyphosisdefo
5、rmitywithCobb’sanglesofthethoracolum2barspinewererangedfrom14°～41°(averageof24°).TheirESRrangedfrom40～110mm/h.19pa2tientshadInparaplegia.Allpatientsreceivedanti-tubercolosischemotherapyfor2～4weeksbeforeopera2tion.Anti-tuberculosischemotherapywasgivenregularlyfor10～12monthsaftersurgery.ResultsAllpati
6、entswerefollowedupfor112～4years(average212years).Thewoundhealedaftersurgery.Thegraftfusedin6～7monthsaftersurgeryand19paraplegiapatientsrecoveredcompletelyin2～4monthsafteroperationand35caseswithkyphosiswascorrectedpartly.TheESRofthesepatientsdecreasedtoanormallevelin3to5monthsaftersurgery.Conclusions
7、Anteriorradicaldebridementwithiliacgraftingandinternalfixationisaneffectivetherapyincuringthespinaltuberculosis.KeywordsThoracolumbarspinaltuberculosis;Anterioroperation;Iliacgrafting;Internalfixation
