【摘要】 目的探讨经侧前路清除脊柱结核病灶的同时椎间钛网植骨融合及椎体侧方固定在治疗胸腰椎结核时的疗效。方法随访我院自2007年6月—2010年6月收治的25例胸腰椎结核的病例,病变阶段椎体术前后凸畸形角度为18.5°～51.6°平均(27.7±6.2)°,均采用侧前路清除脊柱结核病灶的同时椎间钛网植骨融合及椎体侧方固定,观察术后脊柱后凸畸形矫正程度、腰背部疼痛缓解情况、脊髓神经功能恢复情况、植骨融合及内固定稳定情况。结果本组病例均获随访,随访时间为7～39月,平均为23个月,无术后并发症,病变阶段椎体术后后凸畸形矫正角度平均为(16.4±5.3)°,术后患者腰背部疼痛缓解,术前伴有脊髓功能障碍的11例患者术后神经功能均有不同程度恢复。术后影像学检查示椎间钛网植骨融合及椎体侧方固定位置良好,椎体序列及高度恢复良好。结论经侧前路清除脊柱结核病灶的同时椎间钛网植骨融合及椎体侧方固定的手术方式有利于彻底切除病灶及椎管减压,并能够较好的维持脊柱的稳定性。更多还原

【Abstract】 Objective Research into the curative effect,which is caused by clearing the focus of tuberculosis through lateral way while mixing embedded bone and titanium mesh cage together among vertebration and fixing the centrum in the therapy of lumbar and thoracic vertebrae tuberculosis.Methods Through random access of 25 cases of lumbar and thoracic vertebrae tuberculosis from June 2007 to June 2010,the angle change of centrum in pathological changes from preoperative to postoperation is from 18.5° to 51.6°,which is 27.7° and plus or minus 6.2° in average.The theropy uses the method of clearing the focus of tuberculosis through lateral way while mixing embedded bone and titanium mesh cage together among vertebration and fixing the centrum,after operation we observed the improvement extent of the back spinal’s kyphosis deformity and the ache relief condition of the small of the back and the function recovery condition of the spinal nerve and the stable condition of bone transplantation fusion and internal fixation.Results The cases were randomly accessed,the period of the random access is from 7 months to 39 months,which is 23 months in average.There is no complications after operation,the angle change of centrum in pathological changes from preoperative to postoperation is 16.4° and plus or minus 5.3° in average,the ache is relieved in the small of the back,the eleven patients who had spinal functional disorder before operation recovered in varying extent.The imaging findings shows that spinal fusion of the titanium mesh cage and the bone transplantation after operation is good,so is the fixation location of the centrum and the recovery of the centrum’s sequence and height.Conclusions The operative technique,which is clearing the focus of tuberculosis through lateral way while mixing embedded bone and titanium mesh cage together among vertebration and fixing the centrum in the therapy of lumbar and thoracic vertebrae tuberculosis,is in favor of cutting off focus and reducing pressure of the spinal canal,and maintain stability of the spinal better.更多还原