| 摘要: |
| ［摘要］ 目的 探讨手术治疗下腰椎结核的效果。方法 对23例下腰椎结核患者行一期前路结核病灶清除、自体髂骨椎体间植骨融合联合腰椎“Z”形前路钛板内固定术，术后常规三联抗结核化疗9～12个月。观察术后局部疼痛缓解、脊髓神经功能恢复、后凸畸形矫正及脊柱稳定性情况。结果 23例患者均获得随访，平均随访时间为28.2个月，所有患者腰背痛症状均消失。术后脊柱后凸Cobb角平均为29.2°（与术前比较，平均矫正角度为20.5°），疼痛VAS评分平均为27分；Frankel分级为D级6例，E级17例；均无结核复发。结论 下腰椎结核患者采用一期前路结核病灶清除、自体髂骨椎体间植骨融合联合腰椎“Z”形前路钛板内固定术治疗，效果满意。 |
| 关键词: 腰椎结核 病灶清除 内固定 植骨融合 |
| DOI：10.3969/j.issn.1674-3806.2012.04.18 |
| 分类号:R 681.5+8 |
| 基金项目: |
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| Experience on surgical treatment of 23 patients with lower lumbar vertebral tuberculosis |
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CHEN Yong, HUANG Zhi-xi, ZHANG Chun-cheng
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The Second Department of Surgery,the People′s Hospital of Fangcheng District,Guangxi 538021,China
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| Abstract: |
| ［Abstract］ Objective To explore the effects of surgical treatment of lower lumbar vertebral tuberculosis.Methods Twenty-three patients with lower lumbar vertebral tuberculosis received one-stage anterior focus elimination, interbody fusion with autogenous iliac bone and anterior Z-titanium plate internal fixation. After operation all patients were treated with the conventional triple anti-tuberculosis medicine for 9～12 months. After operation, local pain alleviation, the spinal nerves function restoration, kyphosis′ correction and the spinal column stable situation were observed.Results All patients were followed up for the average 28.2 months. In all patients low back pain symptom disappeared. After operation, the average kyphosis Cobb angle was 29.2° (the average correction angle was 20.5°compared with that before the operation), average VAS grading was 27 points; the Frankel graduation showed the D level in 6 patients, the E level in 17 patients; no recurrence of tuberculosis was found. Conclusion The effect of one-stage anterior focus elimination,interbody fusion with autogenous iliac bone and anterior Z-titanium plate internal fixation in the treatment of patients with lower lumbar vertebral tuberculosis is satisfactory. |
| Key words: Lumbar vertebral tuberculosis Focus elimination Internal fixation Bone grafting fusion |
