CAJ | 학술논문

目的：探究单纯自体髂骨块植骨与钛网植骨治疗胸腰椎结核的临床效果。方法回顾性分析本院2007年2月至2013年1月采用彻底病灶清除、植骨融合内固定术治疗的67例胸腰椎结核患者，其中单纯自体髂骨块植骨融合内固定术31例（A组），钛网植骨融合内固定术36例（B组）。比较两组患者手术前后美国脊髓损伤协会（ASIA）评分分级、Cobb角及末次随访丢失情况、植骨融合率、手术时间、术中出血量、住院天数及术后引流量。结果所有患者随访时间为22～53个月，平均39.5个月。两组患者术后神经功能较术前均有改善，但差异无显著性（P＞0.05），术后Cobb角较术前明显减小（P＜0.05），末次随访时两组患者Cobb角丢失度比较差异无显著性（P＞0.05）。A组患者手术时间、术中出血量均少于B组（P＜0.05）；两组患者住院时间、术后引流量及植骨融合率比较差异均无显著性（P＞0.05）。结论钛网植骨较单纯自体髂骨块植骨，植入更加方便，可以有效缩短手术时间、减少术中出血量，是治疗胸腰椎结核的一种安全有效的方法。
목적：탐구단순자체가골괴식골여태망식골치료흉요추결핵적림상효과。방법회고성분석본원2007년2월지2013년1월채용철저병조청제、식골융합내고정술치료적67례흉요추결핵환자，기중단순자체가골괴식골융합내고정술31례（A조），태망식골융합내고정술36례（B조）。비교량조환자수술전후미국척수손상협회（ASIA）평분분급、Cobb각급말차수방주실정황、식골융합솔、수술시간、술중출혈량、주원천수급술후인류량。결과소유환자수방시간위22～53개월，평균39.5개월。량조환자술후신경공능교술전균유개선，단차이무현저성（P＞0.05），술후Cobb각교술전명현감소（P＜0.05），말차수방시량조환자Cobb각주실도비교차이무현저성（P＞0.05）。A조환자수술시간、술중출혈량균소우B조（P＜0.05）；량조환자주원시간、술후인류량급식골융합솔비교차이균무현저성（P＞0.05）。결론태망식골교단순자체가골괴식골，식입경가방편，가이유효축단수술시간、감소술중출혈량，시치료흉요추결핵적일충안전유효적방법。
Objective To investigate the clinical efifcacy of autogenous iliac bone graft alone and iliac bone graft associated with titanium mesh on thoracolumbar spinal tuberculosis treatment. Method Retrospective analysed of 67 cases of patients with thoracolumbar spinal tuberculosis that were treated by thorough focal debridement and internal ifxation of bone graft for fusion from February 2007 to January 2013 in our hospital were proceeded. There were 31 cases of patients treated with internal fixation of simple autogenous iliac bone graft for fusion (group A), and 36 cases of patients treated with internal fixation of iliac bone graft associated with titanium mesh for fusion (group B). The following indexes of the two groups before and after surgery were compared, they were:grading according to American Spinal Injury Association (ASIA), Cobb angle and the loss of it at the last follow-up, fusion rate of bone graft, operative time, transoperative bleeding volume, hospitalization time and postoperative drainage volume. Result The time of follow-up was 22 to 53 months, the average of which was 39.5 months. The postoperative neurological function in the two groups had improved, but with no signiifcant difference (P>0.05). Cobb angle signiifcantly decreased after surgery (P < 0.05). In comparison of Cobb angle loss between the two groups at the last follow-up, there was no signiifcant difference (P>0.05). The operative time and transoperative bleeding volume in group A was less than that in group B (P < 0.05). There were no signiifcant difference of hospitalization time, postoperative drainage volume and bone graft fusion rate between the two groups (P>0.05). Conclusion Bone graft with titanium mesh is more facile for grafting compared with autogenous iliac bone graft alone. It could effectively shorten operative time and decrease transoperative bleeding volume. It is a safe and efficient approach of treating thoracolumbar spinal tuberculosis.