两种手术方法治疗胸腰椎结核的效果观察

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1、两种手术方法治疗胸腰椎结核的效果观（四川省泸州市人民医院骨科，四川泸州646000）[摘要]目的：探析两种手术方法治疗胸腰椎结核患者的效果，为临床合理选择胸腰椎结核的手术方法提供参考。方法：随机抽取2009年1月-2015年1月我院治疗的60例胸腰椎结核，随机分为两组，对照组实施前路病灶清除椎体间植骨融合内固定术，观察组实施后路病灶清除椎体间植骨融合内固定术，统计与比较两组患者的治疗效果。结果：两组患者的手术时间、术中出血量、术前术后及末次随访时血沉、住院时间均无明显差异（P>；0.05）；所有患者随访12-18个月，平均16.8个月，两组患者的病灶情况、植骨融合

2、情况无明显差异（P>0.05）;但末次随访时观察组患者的内固定失败率及术前-末次随访时后凸畸形矫正率与对照组的差异性显著（P<0.05）。两组患者术前-末次随访时脊髓功能ASIA分级分别明显改善率（P<0.05）。结论：两种手术方法治疗胸腰椎结核均可获得满意的疗效，但后路病灶清除椎体间楨骨融合内固定术可明显减少内固定失败率，提高后凸畸形矫正率，是一种较理想的治疗胸腰椎结核的手术方式。关键词：胸腰椎结核；后路；病灶清除；植骨融合；内固定术[abstract]objective:toanalyzetwokindsofsurgicalmethodsforthetrea

3、tmentofthoracolumbartuberculosispatients,forclinicalprovidereferenceforrationalselectionofsurgicalmethodofthoracolumbartuberculosis.Methods:randomlyselectedinJanuary2009-January2015inourtreatmentof60casesofthoracolumbartuberculosis,randomlydividedintotwogroups,controlgroupimplementation

4、ofanteriorlesionclearancebetweenvertebralbodybonegraftfusionandinternalfixation,theobservationgroupimplementationofposteriorlesionclearancebetweenvertebralbodybonegraftfusionandinternalfixation,statisticsandcomparethetherapeuticeffectoftwogroupsofpatients.Results:twogroupsofpatientswith

5、operationtime,intraoperativebloodloss,postoperativeandpreoperativebloodsedimentationatthetimeofthelastfollow-up,lengthofhospitalstaywerenoobviousdifference(P>0.05);Allpatientswerefollowedupfor12to18months,anaverageof16.8months,twogroupsofpatientswithlesions,bonegraftfusionofnosignifi

6、cantdifference(P>0.05);Butatthetimeofthelastfollow-upinternalfixationfailurerateintheobservationgroupofpatientsandpreoperative-atthetimeofthelastfollow-upafterthedifferencesofprotrusiondeformitycorrectionrateandthecontrolgroupsignificantly(P<0.05).Twogroupsofpatientswithpreoperati

7、ve•ASIAhiberarchyfunctionofspinalcordwasobviouslyatthetimeofthelastfollow-upperiod(P<0.05).Conclusion:twomethodsofsurgicaltreatmentofthoracolumbartuberculosiscanobtainsatisfactorycurativeeffect,buttheposteriorlesionclearancebetweenvertebralbodybonegraftfusionandinternalfixat