一期后路病灶清除、椎体间植骨融合内固定治疗腰骶段脊柱结核的疗效(1)
【摘要】 目的 探讨一期后路病灶清除、椎体间植骨融合内固定治疗腰骶段脊柱结核的临床疗效。方法 对16例腰骶段脊柱结核患者采取一期后路病灶清除、椎体间植骨融合内固定术。男5例，女11例，年龄20~56岁，平均38岁。病变累及L4/5者7例，L5/S1者9例。手术前、后检查红细胞沉降率， X线片上测量腰骶角、椎间隙高度评估结核活动、植骨融合和畸形矫正情况。术前腰骶角平均18.6°；椎间隙高度平均7.9 mm。结果 手术时间平均180 min，术中出血平均475 ml。术中无主要血管、神经损伤及严重并发症发生。本组优14例，良2例，优良率为100%，16例植骨全部确定融合。术后腰骶角平均27.1°；末次随访平均25.9°。术后椎间隙高度平均10.6 mm，与术前比较平均撑开高度2.7 mm，末次随访时平均10.4 mm，丢失小于1.0 mm。术前与术后及末次随访结果比较差异具有统计学意义(P<0.05)。随访平均30个月，无结核病变复发、内固定松动、断裂及明显矫正度丢失等严重并发症发生。结论 对腰骶段脊柱结核的患者采取一期后路病灶清除、椎体间植骨融合内固定手术是一较为有效、可行的方法。
, 百拇医药
【关键词】腰骶段；脊柱结核；后路手术；内固定
One-stage posterior radical eradication、bone graft fusion and instrumentation in treating of the lumbosacral tuberculosis
Turghunjan•Abdurxit，SHENG Wei-bin et al.
Department of Spine Surgery, Sixth Infirmary Hospital of Xinjiang Medical University，Urumqi830002,China
, 百拇医药
【Abstract】 Objective To investigate clinical indications of one-stage posterior radical eradication, bone graft fusion and instrumentation in treatment of the lumbosacral tuberculosis.Methods Sixteen cases with tuberculosis of the lumbosacral spine were treated by one-stage posterior radical eradication, bone graft fusion and instrumentation fixation. All patients included 5 males and 11 females, and the average age was 38 years ( range 20~56 years ). The affection segment of L4/5 was seven and L5/S1 was nine. ESR(erythrocyte sedimentation rate)，Roentgenogram of the lumbosacral angle and intervertebral space altitude were concerned to estimate the progress of the tuberculosis activity, bone graft fusion and states of the deformity correction between the preoperative and postoperative. The average lumbosacral angle of the preoperative was 18.6°, the average intervertebral space altitude of the preoperative was 7.9 mm.Results The average operation time was 180 min. The average blood loss during the operation was 475 ml. There were not the main vessel and nerve injury and serious complications in the operation. In this study, fourteen cases was excellent and two cases was good and the fineness rate was 100%, sixteen cases were all had definitive fusion. The averagelumbosacral angle of the postoperative was 27.1°, and the average lumbosacral angle was 25.9° at the late follow-up. The average intervertebral space of the postoperative was 10.6 mm , the average altitude brace was 2.7 mm to compare with the preoperative,the average intervertevral space height was 10.4 mm at the late follow-up and the loss height smaller under 1.0 mm. We found that it had the statistical significance between preoperative and postoperative as well as late follow-up (P<0.05).Conclusion One-stage posterior radical eradication, bone graft fusion and instrumentation in treatment of the lumbosacral tuberculosis is a feasible and an effective procedure in course of treatment.
, 百拇医药
【Key words】Lumbosacral; Spinal tuberculosis; Posterior approach operation; Internal fixation
脊柱结核的手术治疗涉及病灶清除和重建稳定型两个方面。近年来，许多学者报道了腰骶椎(L4/5、L5/S1)结核经前路病灶清除、植骨后路内固定技术，并取得了良好的效果[1-3]。自2002年开始笔者对腰骶椎结核采用一期后路病灶清除、椎体间植骨融合经椎弓根内固定术。本研究旨在探讨该手术的临床应用指征，以期为腰骶椎结核提供新的治疗方法。
, http://www.100md.com(吐尔洪江·阿布都热西提 盛伟斌 郑新峰 金格勒 买尔旦 普拉)
, 百拇医药
【关键词】腰骶段；脊柱结核；后路手术；内固定
One-stage posterior radical eradication、bone graft fusion and instrumentation in treating of the lumbosacral tuberculosis
Turghunjan•Abdurxit，SHENG Wei-bin et al.
Department of Spine Surgery, Sixth Infirmary Hospital of Xinjiang Medical University，Urumqi830002,China
, 百拇医药
【Abstract】 Objective To investigate clinical indications of one-stage posterior radical eradication, bone graft fusion and instrumentation in treatment of the lumbosacral tuberculosis.Methods Sixteen cases with tuberculosis of the lumbosacral spine were treated by one-stage posterior radical eradication, bone graft fusion and instrumentation fixation. All patients included 5 males and 11 females, and the average age was 38 years ( range 20~56 years ). The affection segment of L4/5 was seven and L5/S1 was nine. ESR(erythrocyte sedimentation rate)，Roentgenogram of the lumbosacral angle and intervertebral space altitude were concerned to estimate the progress of the tuberculosis activity, bone graft fusion and states of the deformity correction between the preoperative and postoperative. The average lumbosacral angle of the preoperative was 18.6°, the average intervertebral space altitude of the preoperative was 7.9 mm.Results The average operation time was 180 min. The average blood loss during the operation was 475 ml. There were not the main vessel and nerve injury and serious complications in the operation. In this study, fourteen cases was excellent and two cases was good and the fineness rate was 100%, sixteen cases were all had definitive fusion. The averagelumbosacral angle of the postoperative was 27.1°, and the average lumbosacral angle was 25.9° at the late follow-up. The average intervertebral space of the postoperative was 10.6 mm , the average altitude brace was 2.7 mm to compare with the preoperative,the average intervertevral space height was 10.4 mm at the late follow-up and the loss height smaller under 1.0 mm. We found that it had the statistical significance between preoperative and postoperative as well as late follow-up (P<0.05).Conclusion One-stage posterior radical eradication, bone graft fusion and instrumentation in treatment of the lumbosacral tuberculosis is a feasible and an effective procedure in course of treatment.
, 百拇医药
【Key words】Lumbosacral; Spinal tuberculosis; Posterior approach operation; Internal fixation
脊柱结核的手术治疗涉及病灶清除和重建稳定型两个方面。近年来，许多学者报道了腰骶椎(L4/5、L5/S1)结核经前路病灶清除、植骨后路内固定技术，并取得了良好的效果[1-3]。自2002年开始笔者对腰骶椎结核采用一期后路病灶清除、椎体间植骨融合经椎弓根内固定术。本研究旨在探讨该手术的临床应用指征，以期为腰骶椎结核提供新的治疗方法。
, http://www.100md.com(吐尔洪江·阿布都热西提 盛伟斌 郑新峰 金格勒 买尔旦 普拉)