钛笼与髂骨块植骨修复椎骨缺损治疗胸腰椎结核的疗效比较

发布时间：2019-01-27 10:05

【摘要】：[目的]探讨后路病灶清除、植骨融合内固定术治疗胸腰椎结核的疗效,并比较钛笼与自体髂骨块植骨重建椎骨缺损的疗效差异。[方法]回顾性分析2011年1月~2013年12月行后路病灶清除、植骨融合内固定治疗的49例单节段胸腰椎结核患者的临床资料。其中钛笼组25例、髂骨块组24例。观察VAS评分、ODI评分、Cobb角和椎间高度的改善及丢失、神经功能恢复情况、植骨融合时间及术后并发症等。[结果]平均随访35.3(15~56)个月;术后植骨均融合。两组Cobb角和椎间高度的矫正较术前改善,组间差异无统计学意义(P0.05)。钛笼组Cobb角和椎间高度丢失明显少于髂骨块组(P0.05)。神经功能较术前明显改善。主要并发症有脑脊液漏(钛笼组1例)、窦道形成(钛笼组和髂骨块组各1例)、术区椎间隙感染(髂骨块组1例),无内置物及取髂骨区相关并发症。[结论]后路手术治疗胸腰椎结核可获得良好的临床疗效,结核病灶累及单节段时自体髂骨与钛笼植骨重建椎骨缺损均是较佳选择。
[Abstract]:[objective] to investigate the effect of posterior debridement and fusion internal fixation on thoracolumbar tuberculosis, and to compare the effect of titanium cage and autogenous iliac bone graft in reconstruction of vertebral defect. [methods] the clinical data of 49 patients with single segmental thoracolumbar tuberculosis treated by posterior debridement and bone graft fusion and internal fixation from January 2011 to December 2013 were retrospectively analyzed. There were 25 cases in titanium cage group and 24 cases in iliac bone graft group. The VAS score, ODI score, the improvement and loss of Cobb angle and intervertebral height, the recovery of nerve function, the time of bone graft fusion and postoperative complications were observed. [results] the average follow-up was 35.3 months (15 ~ 56 months). The correction of Cobb angle and intervertebral height in the two groups were improved compared with those before operation, and there was no significant difference between the two groups (P0.05). The loss of Cobb angle and intervertebral height in titanium cage group was significantly lower than that in iliac bone graft group (P0.05). The nerve function was improved significantly. The main complications included cerebrospinal fluid leakage (1 case in the titanium cage group), sinus formation (1 case in the titanium cage group and 1 case in the iliac bone graft group), intervertebral space infection (1 case in the iliac bone graft group), and no complications associated with insertion and extraction of the iliac bone region. [conclusion] posterior surgical treatment of thoracolumbar tuberculosis can obtain a good clinical effect. Autogenous iliac bone and titanium cage graft are the best choice for reconstruction of vertebral defect.
【作者单位】：重庆医科大学附属第一医院骨科;
【分类号】：R687.3

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