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徐松,解京明,王迎松,张颖.脊柱结核的外科治疗[J].脊柱外科杂志,2006,4(1):8-11.
脊柱结核的外科治疗     点此下载全文 (Fulltext)
徐松  解京明  王迎松  张颖
650101 云南, 昆明医学院第二附属医院骨科;650101 云南, 昆明医学院第二附属医院骨科;650101 云南, 昆明医学院第二附属医院骨科;650101 云南, 昆明医学院第二附属医院骨科
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摘要:
      目的 根据脊柱稳定性的状况,探讨脊柱结核外科治疗的术式选择。方法 本组为1997年10月~2005年2月手术治疗的脊柱结核患者共72例,根据结核破坏程度及手术可能带来的脊柱稳定性改变,采用不同的手术治疗方式。结果 本组有1例术后慢性窦道形成,其他患者切口均Ⅰ期愈合。57例有脊柱后凸畸形者,后凸畸形平均矫正27.8°,随访中平均丢失2.4°。55例前路椎体间植骨病例,界面骨性融合时间平均4个月。47例有明显神经损害的患者手术后除1例外均获得明显改善。结论 脊柱稳定性在脊柱结核外科治疗中有重要意义,根据脊柱稳定性改变选择合适的外科治疗术式,均可获得满意的临床疗效。
关键词:脊柱结核  内固定器  脊柱融合术
Surgical treatment of spinal tuberculosis    Fulltext
XU Song  XIE Jingming  WANG Yingsong
Department of Orthopaedics, the NO. 2 Affiliated Hospital of Kunming Medical College, Kunming 650101, China;Department of Orthopaedics, the NO. 2 Affiliated Hospital of Kunming Medical College, Kunming 650101, China;Department of Orthopaedics, the NO. 2 Affiliated Hospital of Kunming Medical College, Kunming 650101, China;Department of Orthopaedics, the NO. 2 Affiliated Hospital of Kunming Medical College, Kunming 650101, China
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Abstract:
      Objective To discuss the selection of surgical procedures for the treatment of spinal tuberculosis according to the status of segmental stability of the spine. Methods Seventy-two patients of spinal tuberculosis were treated surgically from October 1997 to February 2005. Different surgical procedures were performed according to the status of segmental stability of the spine. Results After operation, chronic sinus tract was formed in one patient. Other patients' incisions all primarily healed. Fifty-seven cases with kyphotic deformity had an average correction of 27.8 degrees postoperatively and an average loss of 2.4 degrees during follow-up. Fifty-five cases with anterior fusion achieved solid fusion in mean 4 months. Forty-seven cases with neurological deficits had an improvement of neurological function postoperatively except one case. Conclusion The maintenance of segmental stability has an important significance in the surgical treatment of spinal tuberculosis. Status of segmental stability of each patient should be evaluated preoperatively. Satisfactory clinical results can be achieved by proper selection of the surgical procedure according to the status of segmental stability.
Keywords:spinal tuberculosis  internal fixators  spinal fusion
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