椎弓根螺钉用于植骨融合术治疗胸腰椎结核的临床研究

目的:探讨椎弓根内固定联合植骨融合术治疗胸腰椎结核的临床效果。方法:回顾性分析2013年5月至2014年5月在我院接受治疗的50例胸腰椎结核患者的临床资料,结合影像资料评价患者手术前后的红细胞沉降率、后凸畸形矫正情况、Frankel分级及术后并发症的发生情况等。结果:所有患者术后病理均证实为脊柱结核,术中27例植入大块自体髂骨,23例植入自体肋骨捆绑植骨。24例采用椎体侧前方钉棒内固定,26例采用后路椎弓根螺钉系统内固定。术中未出现脊髓、神经、血管损伤及血气胸等并发症。患者术后红细胞沉降率获得改善,差异具有统计学意义(P0.05)。术后Cobb角明显获得矫正,差异具有统计学意义(P0.05)。患者术后脊柱损伤程度明显改善,差异具有统计学意义(P0.05)。结论:椎弓根内固定联合椎体间植骨融合术治疗胸腰椎结核具有良好的临床效果,不仅可以改善红细胞沉降率,而且可以矫正患者脊柱后凸畸形,值得临床推广应用。

Clinical Study of Pedicle Screw Fixation Combined Bone Graft Fusion for the Thoracolumbar Tuberculosis

Objective:To investigate the curative effect of the pedicle screw fixation combined with bone graft fusion for thoracolumbar tuberculosis.Methods:Clinical data of 50 cases of thoracic and lumbar tuberculosis patients was collected fromMay 2013 to May 2014 in our hospital, and a retrospective analysis was performed. Combined with the radiographic data of patients, the erythrocyte sedimentation rate, kyphosis correction, Frankel grading and postoperative complications was evaluated before and after surgery.Results:All patients were pathologically confirmed vertebral tuberculosis, 27 cases of intraoperative autologous ilium implantation, and 23 cases of autologous rib binding implantation. 24 cases were treated with the anterolateral branch of the vertebral pedicle screw fixation, and 26 cases were treated with posterior branch of pedicle system fixation. During the operation, there was no complication such as the injury of spinal cord, nerves and blood vessels, and the pneumothorax or hemopneumothorax. After operation, the erythrocyte sedimentation rate was improved, and the difference was statistically significant (P<0.05). Cobb angle was obviously amolirated after treatment, and the difference was statistically significant (P<0.05). The degree of postoperative vertebral injury was significantly improved, and the difference was statistically significant (P<0.05).Conclusion:The pedicle screw fixation combined with bone graft fusion has a good clinical effect for the treatment of thoracolumbar tuberculosis, which not only can improve the erythrocyte sedimentation rate, but also can correct the kyphosis deformity, worthy of clinical application.