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疗效

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1、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疗效【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7.9mm。结果手术时间平均180min，术中出血平均475ml。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

2、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10.6mm，与术前比较平均撑开高度2.7mm，末次随访时平均10.4mm，丢失小于1.0mm。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。�【关键词】腰骶段；脊柱结核；后路手术；内固定13��One-stageposteriorradicaleradication、bonegraftfusionandinst

3、rumentationintreatingofthelumbosacraltuberculosisTurghunjan•Abdurxit，SHENGWei-binetal.DepartmentofSpineSurgery,SixthInfirmaryHospitalofXinjiangMedicalUniversity，Urumqi830002,China�【Abstract】ObjectiveToinvestigateclinicalindicationsofone-stageposteriorradicaleradication,bonegraftfusionandinstru

4、mentationintreatmentofthelumbosacraltuberculosis.MethodsSixteencaseswithtuberculosisofthelumbosacralspineweretreatedbyone-stageposteriorradicaleradication,bonegraftfusionandinstrumentationfixation.Allpatientsincluded5malesand11females,andtheaverageagewas38years(range20~56years).Theaffectionsegmentof

5、L4/5wassevenandL5/S1wasnine.ESR(erythrocytesedimentationrate)，Roentgenogramofthelumbosacralangleand13intervertebralspacealtitudewereconcernedtoestimatetheprogressofthetuberculosisactivity,bonegraftfusionandstatesofthedeformitycorrectionbetweenthepreoperativeandpostoperative.Theaveragelumbosacralangl

6、eofthepreoperativewas18.6°,theaverageintervertebralspacealtitudeofthepreoperativewas7.9mm.ResultsTheaverageoperationtimewas180min.Theaveragebloodlossduringtheoperationwas475ml.Therewerenotthemainvesselandnerveinjuryandseriouscomplicationsintheoperation.Inthisstudy,fourteencaseswasexcellentandtwocase

7、swasgoodandthefinenessratewas100%,sixteencaseswereallhaddefinitivefusion.Theaveragelumbosacralangleofthepostoperativewas27.1°,andtheaveragelumbosacralanglewas25.9°atthelatefollow-up.Theaverageinterver