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1、钛网支撑治疗胸腰椎结核30例分析作者：土克军，李照文,廖全明，王志贵,王宜山单位：胸椎；腰椎；脊柱结核；钛网支撑；内固定［摘要］目的探讨胸、腰椎结核一期病灶淸除加植件融合内固定的疗效。方法本组30例，男16例，女14例；平均年龄32.4岁（17〜55岁）。病变部位：胸椎9例，胸、腰段6例，腰椎15例。2个椎体21例，3个椎体7例，4个椎体1例，跳跃型1例。椎旁脓肿24例，骼窝流注性脓肿6例。木组患者伴有后凸畸形26例，平均Cobb角42.8°o术前血沉介于34〜142mm/h。木组患者术前常规抗密（异烟册、利福平、乙胺丁醇、链霉索）1〜2周，手术方式为一期
2、病灶淸除、脊髓减压、前方钛网支撐畸形矫止、口体翳骨（或肋骨）植骨融合内固定术。术后继续抗癘治疗12个月，定期复查胸腰椎止侧位片、血沉、肝肾功能等。结果切口皆一期愈合，无窦道形成。随访6〜36个月（平均12个月），畸形矫正、植骨融合满意，未见内固定失败，疼痛等症状消失，脊髓功能皆明显恢复。2例出现神经根刺激症状，3例感伤口区麻木。术后血沉恢复正常时间平均为3〜11个月。结论胸、腰椎结核行一期病灶清除、脊髄减压、植骨融合，同时前方钛网支撑畸形矫正和内固定治疗，在临床上取得了满意的疗效且不良反应少。［关键词］胸椎；腰椎；脊柱结核；钛网支撑；内固定Operativesur
3、gicalprocedursestreatmentspinaltuberculosis30casesWnagkejun,lizhaowen,liaominquanetal.DepartmentoforthopedicJinzhoucenterhospital［Abstract］ObjectiveToobservetheefficacyofone-stageradicaldebridement,defornitycorrection,interbodyfusionandstabilityreconstructionwithcageforthespinaltuberc
4、ulosistreatment.MethodsTherewere30casesinthegroup,16malesand14femaleswithanaverageageof32.4years（17-55years）.Thelesionswerelocatedatthoracicin9cases,thoracolunbarin6casesandlumbarin15cases・Twovertebraswereaffectedin21cases,threein7casesandfourin1case.24caseshadpara・vertebralabscess,an
5、d6hadpsoasabscess.ThecaseswereallassociatedwithkyphosisdeformitywithanaverageCObbangleof42.8degrees・ThepreoperativeESRwasranged34-142mm/h.Allthepatientsaccepted1・2weeksAnti-TBtherapy,thenunderwentone-stageradicaldebridement,abscessdrainage,spinalcorddecompression,deformitycorrection,i
6、nterbodyandstabilityreconstructionwithcagethroughanteriorapproach.Afterthesurgery,theyacceptedanother12-monthAnti-TBtherapyandtookimage,ESRandtheliverfunctionexaminationsatintervals.ResultsAllthepatientsacquiredsatisfactoryincisionhealing.Follow-upperiodextendedfrom6monthsto36months（m
7、ean12months）.Thegraftgotfusionandtherewasnointernalfixationfailureorrecurrence・Paingotdissapearedandneurologicalfunctionwasimprovedinallpatientsindifferentdegrees・Twocaseshadnerverootsincitementsymptom,andthreecasesfeltanaesthesiaattheareaofopration.Therewasnopyothoraxorlateneurologic
8、aldef
