姜力元;胡建中;陈静;刘少华;高琪乐;李平;胥茜;邓展生;

• 1:中南大学湘雅医院脊柱外科湘雅脊柱外科中心

摘要(Abstract)：

[目的]探讨一期后路单侧椎板开窗、经椎间隙病灶清除植骨融合内固定治疗胸腰段脊柱结核的可行性及临床疗效。[方法]2007年1月~2014年1月收集23例胸腰段脊柱结核并有后突畸形的患者,伴有椎管及椎旁脓肿形成。其中男13例,女10例;年龄30~69岁,平均(46.48±12.01)岁。脊柱病变节段后凸Cobb角为17°~40°,平均(30.43±5.74)°。术前ASIA分级:B级2例,C级10例,D级7例,E级4例。均采用一期后路单侧椎板开窗、经椎间隙病灶清除植骨融合内固定治疗。通过研究患者ASIA分级、脊柱病变节段后凸Cobb角、术后并发症、Oswestry功能障碍指数(ODI)、VAS疼痛评分、植骨融合时间评估手术疗效。[结果]术后随访21~41个月,平均(29.30±4.97)个月,无脊髓损伤加重及脑脊液漏,无窦道形成。1例术后伤口延迟愈合,1例出现皮下局部脓肿。术前有神经症状者均有不同程度恢复。至末次随访,根据ASIA分级,2例由B级恢复至D级,8例由C级恢复至E级,2例由C级恢复至D级,7例由D级恢复至E级。术后测量后凸Cobb角较术前显著改善(P<0.001)。末次随访时ODI、VAS疼痛评分均较术前明显改善(P<0.001)。本组无内固定失败及假关节形成,所有患者均在术后5~8个月达到植骨融合,疗效满意。[结论]对于有适应证的脊柱结核,一期后路单侧椎板开窗、经椎间隙病灶清除植骨融合内固定治疗胸腰段脊柱结核安全有效且手术创伤小。

关键词(KeyWords)： 胸腰段脊柱结核;一期后路;内固定

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 姜力元;胡建中;陈静;刘少华;高琪乐;李平;胥茜;邓展生;

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参考文献(References)：

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