【作者】 王自立； 施建党； 赵浩宁； 陈军；

【Author】 (Department of Orthopedics of the Affiliated Hospital of Ningxia Medical College, Yingchuan, Ningxia 750004, China) Wang Zili, Shi Jiandang

【机构】 宁夏医学院附属医院；

【摘要】 目的探讨累及骶椎的腰骶段脊柱结核手术治疗的方法及疗效。方法2000年1月-2004年1 月间采用后路内固定并前路病灶清除椎体间植骨融合术治疗累及骶椎的腰骶段脊往结核患者22例,后路内固定采用椎弓系统。男性16例,女性6饲,年龄17～65岁,平均40岁。病变部位L4-S42例,L4-S116 例,L5-S14例,伴有一侧或双侧腰大肌脓肿。术前抗痨活疗至少2周以上。前路病灶清除后,采用自体髂骨移植18例,钛网植骨融合4例。结果随访20例,平均随访时间14个月。植骨块无滑脱,骨性融合时间5个月。内固定无松动,无腰痛及功能受限,结核局部病灶无复发。所有患者切口均一期愈合。结论一期后路内固定加前路病灶清除椎体间植骨融合术治疗累及骶椎的腰骶段脊柱结核的疗效确切,能达到彻底清除病灶和重建腰骶稳定的目的。更多还原

【Abstract】 Objective: To analyze the clinical results of surgical management for lumbar- sacral segment tuberculosis that involving sacrum. Methods: 22 patients with lumbar - sacral segment tuberculosis who were treated surgically by a single stage from Jan 2000 to Jan 2004 were reviewed retrospectively. The patients with lumbar and sacrum spinal tubercuiosis were treated surgically by posterior instrumentation and anterior resection plus interbody autografting. Posterior instrumentation was used in transvertebral pedicle system. There are sixteen male cases and six female case with age from 17 to 65(average 40). Twelve eases located in L4 - S4 and six in L4 - S1, accompanied by moaolateral orbilateral psoas major muscle abscess. After anterior debridement autogarft was transplanted in 18 case, titanium cage bone transplanting were used in 4 cases. Results: AII patients had incision healed without infection or -inus formation. All patients were followed up with average of 14months. No slip paged bone block or loosening internal fixation instrument was found. Spinal solid fusion was shown radiologically in 5 months on the average. No chronic back pain, restricted function and relapse were found. Conclusion: One. - stage surgical management by posterior instrumentation and anterior resection pins interbody autografting is an effective surgery to lumbarsacral spinal tuberculosis.更多还原