中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (39): 7315-7318.doi: 10.3969/j.issn.1673-8225.2011.39.024

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

腰椎后路椎弓根钉置入并自体颗粒骨打压植骨治疗下腰椎结核

李  健,张振山,杨  波,赵洪普,吴溢峰   

  1. 广州医学院第三附属医院骨科,广东省广州市510150
  • 收稿日期:2011-04-13 修回日期:2011-08-28 出版日期:2011-09-24
  • 通讯作者: 张振山,硕士,医师,广州医学院第三附属医院骨科,广东省广州市510150 doczhangzhen@126.com
  • 作者简介:李健,男,1953年生,江苏省无锡市人,汉族,1975年解放军第一军医大学毕业,教授,主任医师,主要从事创伤外科、脊柱外科的研究。

Application of posterior lumbar interbody fusion with autogenous morselized bone graft impaction in low-lumbar tuberculosis 

Li Jian, Zhang Zhen-shan, Yang Bo, Zhao Hong-pu, Wu Yi-feng   

  1. Department of Orthopedics, Third Affiliated Hospital of Guangzhou Medical College, Guangzhou  510150, Guangdong Province, China
  • Received:2011-04-13 Revised:2011-08-28 Online:2011-09-24
  • Contact: Zhang Zhen-shan, Master, Physician, Department of Orthopedics, Third Affiliated Hospital of Guangzhou Medical College, Guangzhou 510150, Guangdong Province, China Doczhangzhen@126.com.cn
  • About author:Li Jian, Professor, Chief physician, Department of Orthopedics, Third Affiliated Hospital of Guangzhou Medical College, Guangzhou 510150, Guangdong Province, China

摘要:

背景:采用自体颗粒骨结合打压植骨技术,行单节段腰椎椎间融合治疗下腰椎结核具有可靠的融合率,但目前临床应用报道不多。
目的:探讨经腰椎后路椎弓根钉置入并自体颗粒骨打压植骨治疗单节段下腰椎结核的临床可行性。
方法:回顾性分析2003-07/2009-07广州医学院第三附属医院骨科收治的单节段下腰椎结核患者20例,均行后路一期病灶清除、自体颗粒骨打压植骨腰椎椎体间融合内固定。置入内固定后评价其神经功能障碍改善、疗效、椎体融合及畸形矫正情况。
结果与结论:所有患者均获得随访,随访时间9~20个月。采用Macnab标准评价临床结果优11例,良8例,中1例,优良率95%。椎间融合率约为90%。内固定未见松脱、断裂等并发症。置入后及末次随访时Cobb角、椎间高度均较置入前有明显改善,差异有显著性意义(P < 0.05)。表明后路一期病灶清除、自体颗粒骨打压植骨腰椎椎体间融合固定是治疗下腰椎结核的有效方法之一。

关键词: 下腰椎, 脊柱结核, 后路手术, 自体颗粒骨, 椎弓根, 打压植骨

Abstract:

BACKGROUND: Autogenous morselized bone graft impaction in the single lumbar segment fusion has reliable fusion rate, but there are few reports about the clinical application.
OBJECTIVE: To investigate the feasibility of posterior lumbar interbody fusion with autogenous morselized bone graft impaction in single operation through single incision in low-lumbar tuberculosis.
METHODS: A total of 20 patients with low-lumbar tuberculosis were treated by posterior lumbar interbody fusion with autogenous morselized bone graft impaction. The clinical outcomes were measured according to Frankel classify, as well as treatment effect, fusion rate and deformity correction.
RESULTS AND CONCLUSION: Twenty cases were followed up for 9 to 20 months. The Macnab criteria revealed that 11 patients had excellent result, 8 had good, and 1 had fair, with a excellent and good rate of 95%. The fusion rate was 90%. No complications were observed. Averaging interbody height and Cobb’s angle at the final follow-up were improved compared with preoperation (P < 0.05). Posterior lumbar interbody fusion with autogenous morselized bone graft impaction in single operation through single incision is an effective treatment for low-lumbar tuberculosis which provides satisfactory effect with high interbody fusion rate and low complication rate.

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