CAJ | 학술논문

目的：探讨一期后路病灶清除、自体骨及硫酸钙人工骨混合植骨、内固定术治疗胸腰椎结核的疗效及安全性。方法对21例胸腰椎结核患者在正规抗结核的基础上采用一期后路病灶清除、含链霉素的硫酸钙人工骨与自体骨混合植骨及内固定术治疗；观察患者局部切口、有无不良反应及临床症状恢复情况。定期影像学检查对植骨融合和后凸畸形矫正的情况进行分析。结果患者术后伤口均一期愈合,临床症状明显缓解,后凸畸形获得不同程度的矫正,矫正角度无明显丢失,无全身不良反应。21例均获随访,时间9~18个月。20例患者一次手术治愈,1例患者于术后9个月结核复发再次行前路手术后治愈。胸腰椎X线检查：术后1周硫酸钙人工骨粒显影清楚,术后3个月显影不清,术后6~9个月植骨部位获骨性愈合。结论一期后路病灶清除、自体骨与含链霉素的硫酸钙人工骨混合植骨融合、内固定术治疗胸腰椎结核是安全、可行的方法。
목적：탐토일기후로병조청제、자체골급류산개인공골혼합식골、내고정술치료흉요추결핵적료효급안전성。방법대21례흉요추결핵환자재정규항결핵적기출상채용일기후로병조청제、함련매소적류산개인공골여자체골혼합식골급내고정술치료；관찰환자국부절구、유무불량반응급림상증상회복정황。정기영상학검사대식골융합화후철기형교정적정황진행분석。결과환자술후상구균일기유합,림상증상명현완해,후철기형획득불동정도적교정,교정각도무명현주실,무전신불량반응。21례균획수방,시간9~18개월。20례환자일차수술치유,1례환자우술후9개월결핵복발재차행전로수술후치유。흉요추X선검사：술후1주류산개인공골립현영청초,술후3개월현영불청,술후6~9개월식골부위획골성유합。결론일기후로병조청제、자체골여함련매소적류산개인공골혼합식골융합、내고정술치료흉요추결핵시안전、가행적방법。
Objective To study the clinical effect and safety of one-stage posterior debridement, medical grade calci-um sulfate artificial bone and autogenetic bone graft and internal fixation in thoraco-lumbar spinal tuberculosis. Meth-ods 21 cases with thoraco-lumbar spinal tuberculosis were treated with one-stage posterior debridement, medical grade calcium sulfate artificial bone in corporaed with streptomycin and autogenetic bone graft,and internal fixation on the basis of regular anti-tuberculosis. Incision healing, adverse reactions and the change of clinical symptoms were re-corded. Bone fusion and deformity correction were analyzed by the regular X-ray examination. Results All patients acquired satisfactory incision healing without obvious general adverse reactions. Clinical symptoms were differently re-lieved. Kyphosis was corrected to some degree and the correction was no loss. 21 cases were followed up for 9~18 months. 20 patients were cured. Tuberculosis recurred in one patient 9 months postoperatively, and was cured after the anterior surgery. X-ray examination showed that the calcium sulfate artificial bone was clear 1 week after surgery and unclear 3 months after surgery. Bone fusion appeared 6~9 months after operation. Conclusions One-stage pos-terior debridement, medical grade calcium sulfate artificial bone with streptomycin and autogenetic bone graft and in-ternal fixation is a safe and effective method of treating thoraco-lumbar spinal tuberculosis.