病灶清除钛网支撑植骨内固定治疗脊柱结核

发布时间：2018-04-05 22:14

本文选题：脊柱结核　切入点：钛网支撑　出处：《广西医科大学》2013年硕士论文

【摘要】：目的进一步探讨脊柱结核病灶清除钛网支撑植骨内固定的疗效。方法回顾性分析42例脊柱结核患者,其中20例患者采用病灶清除钛网支撑植骨内固定治疗,同期22例患者采用病灶清除骨块支撑植骨内固定治疗,对两组患者手术前后视觉模拟评分、手术前后病变节段椎间前缘高度变化情况、术后畸形矫正情况、植骨融合情况、脊柱结核治愈情况进行了随访观察和统计学比较。结果所有患者术后随访20-56个月,平均35.5个月,所有患者结核无复发,手术切口均甲级愈合,两组患者末次随访时视觉模拟评分与术前比较有明显改善,两组间比较无统计学意义(P0.05),术后末次随访时后凸角度、病变节段椎间前缘高度与术前比较有明显矫正和恢复,两组间比较无统计学意义(P0.05),两组患者植骨融合时间比较差异有显著性(P0.05),两组患者的脊柱结核均治愈。结论对术中存在1个以上椎体病损的脊柱结核钛网支撑植骨疗效满意,与传统骨块支撑相比疗效一样,但植骨融合时间明显缩短,支持患者早期下床活动,有利于患者术后护理及康复治疗,但术中要注意钛网置放位置,掌握好钛网植骨范围。
[Abstract]:Objective to investigate the effect of titanium mesh support bone graft fixation for spinal tuberculosis.Methods 42 patients with spinal tuberculosis were retrospectively analyzed, 20 of them were treated with debridement and titanium mesh supported bone graft fixation, and 22 patients were treated with debridement bone mass support and bone graft internal fixation at the same time.The visual analogue score before and after operation, the height change of the anterior edge of the diseased segmental vertebrae before and after operation, the correction of deformity, the fusion of bone graft and the cure of spinal tuberculosis were followed up and compared statistically between the two groups.Results all the patients were followed up for 20-56 months with an average of 35.5 months. There was no recurrence of tuberculosis in all patients and the incision healed in grade A. the visual analogue score of the two groups at the last follow-up was significantly improved compared with that before operation.There was no significant difference between the two groups (P 0.05). The kyphosis angle and the anterior height of the diseased intervertebral segment were significantly corrected and recovered after the last follow-up.There was no significant difference between the two groups (P 0.05). There was a significant difference in the time of bone grafting and fusion between the two groups. The spinal tuberculosis was cured in both groups.Conclusion the effect of titanium mesh support for spinal tuberculosis with more than one vertebral body lesion during operation is satisfactory, which is the same as that of traditional bone mass support, but the time of bone graft fusion is obviously shortened, which supports the patients to get out of bed early.It is beneficial to postoperative nursing and rehabilitation treatment, but attention should be paid to the position of titanium mesh during operation, and the range of titanium mesh bone graft should be grasped.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R687.3;R529.2

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