Zhao Jie, Lian Xiao Feng, Hou Tie Sheng, Ma Hui, Chen Zhi Ming
Department of Orthopaedics, Changhai Hospital, 174 Changhai Road, Shanghai, 200433, People's Republic of China.
Int Orthop. 2007 Dec;31(6):859-63. doi: 10.1007/s00264-006-0253-1. Epub 2006 Oct 24.
Between 2000 and 2004, 40 cases (average age 38, range 16-65 years) of spinal tuberculosis were treated with anterior debridement and iliac bone graft with one-stage anterior or posterior instrumentation in our unit. All patients received at least 2 weeks of regular antituberculous chemotherapy before surgery. We followed up all patients for 12-48 months (mean 22 months). Local symptoms of all patients were relieved significantly 1-3 weeks postoperatively; 23 of 25 cases (92%) with neurogical deficit had excellent or good clinical results. Erythrocyte sedimentation rates (ESR) returned from 51 mm/h to 32 mm/h (average) two weeks postoperatively. Kyphosis degrees were corrected by a mean of 16 degrees . Fusion rate of the grafting bone was 72.5% one year postoperatively and 90% two years postoperatively. Severe complications did not occur. We therefore believe that patients undergoing anterior debridement and iliac bone grafting with one-stage anterior or posterior instrumentation achieve satisfactory clinical and radiographic outcomes.
2000年至2004年期间，我院对40例脊柱结核患者（平均年龄38岁，年龄范围16 - 65岁）采用前路清创、髂骨植骨并一期前路或后路内固定治疗。所有患者在手术前均接受了至少2周的正规抗结核化疗。我们对所有患者进行了12 - 48个月（平均22个月）的随访。所有患者的局部症状在术后1 - 3周明显缓解；25例神经功能缺损患者中有23例（92%）临床效果优良。术后两周红细胞沉降率（ESR）从51 mm/h降至32 mm/h（平均）。后凸畸形平均矫正16度。术后一年植骨融合率为72.5%，术后两年为90%。未发生严重并发症。因此，我们认为接受前路清创、髂骨植骨并一期前路或后路内固定的患者可获得满意的临床和影像学结果。
