一期前后路联合手术治疗胸腰椎结核并瘫痪(1)
 |
| 第1页 |
参见附件(4174KB，4页)。
[摘要] 目的：评价一期后路内固定并后外侧融合、前路病灶清除、植骨融合术治疗胸、腰椎结核并瘫痪的临床疗效。方法：回顾性分析我院2005年1月～2008年12月23例胸、腰椎结核伴瘫痪的患者，联合化疗(HREZ方案)2周以后，行一期后路内固定并后外侧融合、前路病灶清除、植骨融合术。结果：随访12～60个月，平均27个月，平均手术时间285 min(240～360 min)，术中出血950 ml(600～1500 ml)。术后伤口全部一期愈合，后凸畸形均明显改善。患者平均Frankel分级上升1.1级，神经根刺激症状全部得到缓解。无围手术期并发症及随访期并发症发生。所有患者最终均获得了良好的骨性融合，无结核复发的病例。结论：一期后路内固定并后外侧融合、前路病灶清除、植骨融合术治疗胸、腰椎结核可以同时解决病灶清除、减压、稳定、融合等问题，对于防止疾病进展、纠正后凸畸形、恢复神经功能具有良好的临床疗效。
[关键词] 脊柱结核；瘫痪；前后路联合；病灶清除；内固定
[中图分类号] R687.3[文献标识码] B [文章编号] 1673-7210(2011)07(b)-078-04
Single stage combined posterior instrumentation and anterior debridement for tuberculosis of thoracic and lumbar spine with paralysis
WANG Jiesheng1, LI Jing2, GAI Jingying2, WANG Xiaobin2
1.Department of Orthopedics, Dong'an County People's Hospital of Hunan Province, Dong'an 425900, China; 2.Department of Spine Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
[Abstract] Objective: To evaluate the efficacy of the single stage procedure combined posterior instrumentation and anterior debridement for treatment of spinal tuberculosis in patients with neurological deficit. Methods: From January 2005 to December 2008, 23 patients of spinal tuberculosis combined with paralysis were enrolled in this study. All patients included 13 males and 10 females, and the average age was 32.4 years (range from 9 to 56 years). There were 14 cases located at thoracic region, 3 cases at thoracolumbar region, 5 cases located at lumbar region; They all had different degree of kyphosis. According to the Frankel's scoring system, there were 5 patients with Frankel Grade B, 7 with Grade C, and 11 with Grade D. Sphincter disturbance was observed in 4 patients and 9 patients had nerve root irritation. All patients underwent single stage posterior instrumentation, postlateral bone grafting, and anterior debridement, decompression and fusion. Results: The average follow-up duration was 27 months (ranged from 12 to 60 months) ......
您现在查看是摘要介绍页，详见PDF附件(4174KB，4页)。