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：

脊柱結核; 病灶清除術; 脊柱融合術; 內固定

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目的:探討后路內固定治療脊柱結核的必要性及適應證。方法:2002年1月~2008年12月采用后路器械固定、融合結合前路徹底病灶清除、植骨治療脊柱結核17例。病變位于胸椎3例,胸腰段2例,腰椎4例,腰骶椎8例;累及2個節段7例,3個節段7例,4個節段3例;有3例伴竇道形成;9例伴不同程度的脊髓和(或)神經根受壓癥狀;術前后凸成角10°~72°,平均31°。所有患者均一期手術。結果:術后隨訪6個月~5年,平均3.1年,術后切口均Ⅰ期愈合,后凸成角7°~58°,平均16°,椎間植骨平均在5個月融合,植骨融合率95.6%,優良率達89.6%,無一例復發。結論:后路器械固定結合前路徹底病灶清除、植骨治療脊柱結核主要適用于多個節段受累、腰骶段及伴竇道者,利于恢復脊柱的穩定性、提高植骨融合率、糾正和預防后凸畸形。

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,徐榮明.寰樞椎椎弓根螺釘固定技術的臨床應用[J].中國脊椎脊髓雜志,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.	馬向陽,尹慶水,劉景發,等.寰椎側塊螺釘與寰椎椎弓根螺釘的解剖與生物力學對比研究[J].中國骨與關節損傷雜志,2005,20(6):361-363..
7.	馬向陽,鐘世鎮,劉景發,等.寰樞椎椎弓根螺釘進釘點的解剖定位研究[J].骨與關節損傷雜志,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,尹慶水,馬向陽,等.寰椎后弓形態分類與椎弓根螺釘固定的解剖學研究[J].中國臨床解剖學雜志,2006,24(3):275-278..
10.	王建華,尹慶水,夏虹,等.樞椎椎動脈孔分型對樞椎椎弓根置釘的臨床意義[J].中國脊椎脊髓雜志,2007,17(8):593-595.〖ZK)〗.
11.	王建華.對樞椎椎弓根復合體與解剖學椎弓根的認識[J].中國脊椎脊髓雜志,2007,17(4):319.〖JY,2〗(收稿日期:2009-01-21).

1.
2. 校佰平,徐榮明.寰樞椎椎弓根螺釘固定技術的臨床應用[J].中國脊椎脊髓雜志,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. 馬向陽,尹慶水,劉景發,等.寰椎側塊螺釘與寰椎椎弓根螺釘的解剖與生物力學對比研究[J].中國骨與關節損傷雜志,2005,20(6):361-363..
7. 馬向陽,鐘世鎮,劉景發,等.寰樞椎椎弓根螺釘進釘點的解剖定位研究[J].骨與關節損傷雜志,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,尹慶水,馬向陽,等.寰椎后弓形態分類與椎弓根螺釘固定的解剖學研究[J].中國臨床解剖學雜志,2006,24(3):275-278..
10. 王建華,尹慶水,夏虹,等.樞椎椎動脈孔分型對樞椎椎弓根置釘的臨床意義[J].中國脊椎脊髓雜志,2007,17(8):593-595.〖ZK)〗.
11. 王建華.對樞椎椎弓根復合體與解剖學椎弓根的認識[J].中國脊椎脊髓雜志,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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