CAJ | 학술논문

目的探讨通过Ⅰ期手术,即后方入路内固定联合前方入路进行胸腰椎结核病灶清除加自体骨移植治疗胸腰椎结核的疗效.方法自2003年9月至2007年9月对16例胸腰椎椎体结核患者采用Ⅰ期后路切开内固定,联合前路暴露病灶,彻底清除结核肉芽组织、脓液、死骨等进行脊髓减压,植入自体髂骨块或肋骨重建前柱;观察植骨融合情况,术前、术后测量影像学胸腰椎Cobbs角,采用美国脊柱损伤学会(A-SIA)神经功能分级评估神经恢复情况.结果随访10～36个月,平均12个月,16例患者均获骨性愈合,结核病变无复发,生理弧度无明显丢失;6例有神经症状的患者,术后均有一定程度的恢复.结论 Ⅰ期后前方入路治疗胸腰椎结核,具有牢固内固定,能彻底清除病灶防止结核复发,重建胸腰椎稳定性,矫正后凸畸形可靠的优势.
목적 탐토통과Ⅰ기수술,즉후방입로내고정연합전방입로진행흉요추결핵병조청제가자체골이식치료흉요추결핵적료효.방법 자2003년9월지2007년9월대16례흉요추추체결핵환자채용Ⅰ기후로절개내고정,연합전로폭로병조,철저청제결핵육아조직、농액、사골등진행척수감압,식입자체가골괴혹륵골중건전주;관찰식골융합정황,술전、술후측량영상학흉요추Cobbs각,채용미국척주손상학회(A-SIA)신경공능분급평고신경회복정황.결과 수방10～36개월,평균12개월,16례환자균획골성유합,결핵병변무복발,생리호도무명현주실;6례유신경증상적환자,술후균유일정정도적회복.결론 Ⅰ기후전방입로치료흉요추결핵,구유뢰고내고정,능철저청제병조방지결핵복발,중건흉요추은정성,교정후철기형가고적우세.
Objective To explore the therapeutic efficacy of posterior internal fixation and anterior debride-ment with autogenous bone grafts at one stage on tuberculosis of thoracic or lumbar spine . Methods 16 cases of thoracic or lumbar spinal tuberculosis patients were treated with combined anterior (radical debridement and bone autograft) and posterior (instrumentation) surgeries in one stage between September 2003 and September 2007. The degree of the kyphosis (Cobb angle) was measured and the interbody fusion was observed preoperatively and postop-eratively. The ASIA grading system was used to assess the neurological status. Results All patients were followed up for 10 months to 36 months,on average of 12 months. All patients showed sucessful interbedy fusion,but Cobb angle was not progressed. No recurrence or wound infection was found. 6 cases all got nerve function recovery. Conclusion Thoracic or lumbar tuberculosis treated with this surgical technique can achieve stable internal fixation and a high satisfactory rate with restoring the spinal stability, arresting the disease early, providing early fusion, correcting the ky-pbosis particularly.