Posteriol Fixation and Fusion for Treatment of Tuberculosis of Spine_West China Medical Journal

Authors：

FENG Daxiong , ZHANG Zhongjie , KANG Jianping

Department of Orthopedic, First Affiliated Hospital of Luzhou Medical Collage, Luzhou Sichuan 646000, China;

Corresponding author：

Keywords：

脊柱结核; 病灶清除术; 脊柱融合术; 内固定

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目的:探讨后路内固定治疗脊柱结核的必要性及适应证。方法:2002年1月~2008年12月采用后路器械固定、融合结合前路彻底病灶清除、植骨治疗脊柱结核17例。病变位于胸椎3例,胸腰段2例,腰椎4例,腰骶椎8例;累及2个节段7例,3个节段7例,4个节段3例;有3例伴窦道形成;9例伴不同程度的脊髓和(或)神经根受压症状;术前后凸成角10°~72°,平均31°。所有患者均一期手术。结果:术后随访6个月~5年,平均3.1年,术后切口均Ⅰ期愈合,后凸成角7°~58°,平均16°,椎间植骨平均在5个月融合,植骨融合率95.6%,优良率达89.6%,无一例复发。结论:后路器械固定结合前路彻底病灶清除、植骨治疗脊柱结核主要适用于多个节段受累、腰骶段及伴窦道者,利于恢复脊柱的稳定性、提高植骨融合率、纠正和预防后凸畸形。

Citation： FENG Daxiong,ZHANG Zhongjie,KANG Jianping. Posteriol Fixation and Fusion for Treatment of Tuberculosis of Spine. West China Medical Journal, 2009, 24(4): 834-836. doi: Copy

1.
2.	校佰平,徐荣明.寰枢椎椎弓根螺钉固定技术的临床应用[J].中国脊椎脊髓杂志,2005,15(11):658-661..
3.	ROBERT P MELCHER, CHRISTIAN M PUTTLITZ, FRANK S KLEINSTUECK, et al. Biomechanical testing of posterior atlantoaxial fixation techniques[J]. Spine,2002,27(22):2435-2440..
4.	THOMAS JLEARCH,JENNIFER B MASSIE,MINI N PATHRIA, et al. Assessment of Pedicle Screw Placement utilizing Conventional radiography and Computed Tomography A proposed systematic approach to improve accuracy of interpratation [J]. Spine,2004,29(7):767-773..
5.	XU R, NADAUD MC, EBRAHEIM N, et al. Morphology of the second cervical vertebra and the posterior projection of the C2 pedicle axis[J]. Spine,1995,20(3):259-263..
6.	马向阳,尹庆水,刘景发,等.寰椎侧块螺钉与寰椎椎弓根螺钉的解剖与生物力学对比研究[J].中国骨与关节损伤杂志,2005,20(6):361-363..
7.	马向阳,钟世镇,刘景发,等.寰枢椎椎弓根螺钉进钉点的解剖定位研究[J].骨与关节损伤杂志,2003,18(10):683-685..
8.	TAN MS, WANG H, WANG Y, et al. Morphometric evaluation of screw fixation in atlas via posterior arch and lateral mass[J]. Spine,2003,28(9):888-895..
9.	何帆,尹庆水,马向阳,等.寰椎后弓形态分类与椎弓根螺钉固定的解剖学研究[J].中国临床解剖学杂志,2006,24(3):275-278..
10.	王建华,尹庆水,夏虹,等.枢椎椎动脉孔分型对枢椎椎弓根置钉的临床意义[J].中国脊椎脊髓杂志,2007,17(8):593-595.〖ZK)〗.
11.	王建华.对枢椎椎弓根复合体与解剖学椎弓根的认识[J].中国脊椎脊髓杂志,2007,17(4):319.〖JY,2〗(收稿日期:2009-01-21).

1.
2. 校佰平,徐荣明.寰枢椎椎弓根螺钉固定技术的临床应用[J].中国脊椎脊髓杂志,2005,15(11):658-661..
3. ROBERT P MELCHER, CHRISTIAN M PUTTLITZ, FRANK S KLEINSTUECK, et al. Biomechanical testing of posterior atlantoaxial fixation techniques[J]. Spine,2002,27(22):2435-2440..
4. THOMAS JLEARCH,JENNIFER B MASSIE,MINI N PATHRIA, et al. Assessment of Pedicle Screw Placement utilizing Conventional radiography and Computed Tomography A proposed systematic approach to improve accuracy of interpratation [J]. Spine,2004,29(7):767-773..
5. XU R, NADAUD MC, EBRAHEIM N, et al. Morphology of the second cervical vertebra and the posterior projection of the C2 pedicle axis[J]. Spine,1995,20(3):259-263..
6. 马向阳,尹庆水,刘景发,等.寰椎侧块螺钉与寰椎椎弓根螺钉的解剖与生物力学对比研究[J].中国骨与关节损伤杂志,2005,20(6):361-363..
7. 马向阳,钟世镇,刘景发,等.寰枢椎椎弓根螺钉进钉点的解剖定位研究[J].骨与关节损伤杂志,2003,18(10):683-685..
8. TAN MS, WANG H, WANG Y, et al. Morphometric evaluation of screw fixation in atlas via posterior arch and lateral mass[J]. Spine,2003,28(9):888-895..
9. 何帆,尹庆水,马向阳,等.寰椎后弓形态分类与椎弓根螺钉固定的解剖学研究[J].中国临床解剖学杂志,2006,24(3):275-278..
10. 王建华,尹庆水,夏虹,等.枢椎椎动脉孔分型对枢椎椎弓根置钉的临床意义[J].中国脊椎脊髓杂志,2007,17(8):593-595.〖ZK)〗.
11. 王建华.对枢椎椎弓根复合体与解剖学椎弓根的认识[J].中国脊椎脊髓杂志,2007,17(4):319.〖JY,2〗(收稿日期:2009-01-21).

West China Medical Journal

Posteriol Fixation and Fusion for Treatment of Tuberculosis of Spine

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