河北医科大学学报

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硬化骨均匀钻孔联合同种异体髂骨块治疗腰椎结核的临床应用

  

  1. 1. 河北省胸科医院骨科,河北 石家庄 050041 ; 2. 河北大学基础医学院 2013 级临床医学本科 1 班,河北 保定 071000
  • 出版日期:2016-02-25 发布日期:2016-04-27
  • 作者简介:董昭良( 1983- ),男,河北晋州人,河北省胸科医院 主治医师,医学硕士,从事骨科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题( 20150603 )

Treatingpatientswithlumbartuberculosisbykeepingscleroticboneuniformlydrilledjoint#br# withimplantingallograftiliacboneforinterbodyfusion

  1. 1. DepartmentofOrthopedics , theChestHospitalofHebeiProvince , Shijiazhuang 050041 , China ;
    2. UndergraduateClass 1 , theSchoolofBasicMedicalSciences , HebeiUniversity ,
    Baoding 071000 , China
  • Online:2016-02-25 Published:2016-04-27

摘要: 目的 探讨硬化骨均匀钻孔联合同种异体髂骨块治疗腰椎结核的临床应用价值。方法 回顾性分析
行硬化骨均匀钻孔联合同种异体髂骨块手术治疗的 47 例腰椎结核患者的临床资料。结果 术后随访 16~24 个
月,
47 例患者结核全部治愈。椎间植骨块融合时间 6~12 个月,按骨融合标准优 37 例,良 8 例,可 2 例,差 0 例。
脊柱后凸畸形 25 例,术后 2 周、末次随访时 Cobb 角低于术前,差异有统计学意义( P <0.01 )。患者神经功能均有
不同程度的恢复。 Frankel 分级:
1 例 A 级恢复至 C 级; 2 例 C 级患者中 1 例恢复至 E 级, 1 例恢复至 D 级; 3 例 D
级患者全部恢复至 E 级。结论 硬化骨均匀钻孔联合同种异体髂骨块前路一期内固定术治疗腰椎结核,临床疗效
肯定,术后恢复好,是治疗腰椎结核的有效方法,值得临床推广应用。

关键词: 结核, 脊柱, 移植, 同种, 治疗结果

Abstract: Toinvestigatethevalueoftreatingpatientswithlumbartuberculosis
bykeepingscleroticboneuniformlydrilledjointwithimplantingallograftiliacboneforinterbody
fusion.Methods Therewere47patientswithlumbartuberculosisinthisretrospectivestudywho
weretreatedbysurgeryofkeepingscleroticboneuniformlydrilledjointwithimplantingallograft
iliacboneforinterbodyfusion.Results Postoperativefollow-upwere16-24 months.Forty-
sevenpatientswithlumbartuberculosiswereallcured.Thebonyfusiontimeof47patientswas6
monthsto12months.Inaccordancewiththestandardofbonefusion , theresultswereexcellent
in37cases , goodin8cases , fairin2cases , andpoorin0case.Kyphosisin25caseswithCobb
anglehavebeenfound , 2weeksafterthesurgeryandthefinalfollow-up , thekyphoticdeformity
werecorrected , andthe difference wasstatistically significant ( P <0.01 ) .The patients'
neurologicalfunctionswereelevatedinvaryingdegrees.TheFrankelgradingshowedthat : 1case
wasrecoveredfromgradeAtogradeC , 1casewasrecoveredfromgradeCtogradeE , 1case
wasrecoveredfromgradeCtogradeD , and3caseswererecoveredfromgradeDtogradeE.
Conclusion Goodsurgicaloutcomeshavebeenfoundinthisstudyandthetechniquethattreating
patients with lumbartuberculosis by keeping sclerotic bone uniformly drilledjoint with
implantingallograftiliacboneforinterbodyfusioncouldbeappliedfurtherintheclinicaltrial.

Key words: tuberculosis, spinal , transplantation, homologous , treatmentoutcome