使用可扩张钛笼重建椎骨骨髓炎的大缺损。
Reconstruction of large defects in vertebral osteomyelitis with expandable titanium cages.
作者信息
Robinson Yohan, Tschoeke Sven Kevin, Kayser Ralph, Boehm Heinrich, Heyde Christoph E
机构信息
Charité-Campus Benjamin Franklin, Center for Trauma and Reconstructive Surgery, Berlin, Germany.
出版信息
Int Orthop. 2009 Jun;33(3):745-9. doi: 10.1007/s00264-008-0567-2. Epub 2008 Jul 5.
Abstract
The purpose of this study was to investigate the outcome of expandable titanium cage implantation in large defects caused by acute vertebral osteomyelitis. Twenty-five patients with acute single or multilevel spondylodiscitis were treated after radical débridement and posterior instrumentation with an anterior expandable titanium cage and bone grafting. Clinical, laboratory and radiological follow-up continued for 36 months. Within the postoperative course there was no recurrence of spinal infection. The final radiological examination showed successful fusion in all cases without implant loosening or failure. At the final follow-up after 36 months the Oswestry Disability Index was 23 +/- 14 and the pain visual analogue scale 2.1 +/- 1.7. This study reveals healing and improved function after expandable titanium cage implantation in all patients. Prerequisites for optimal healing include radical débridement, provision of stability for weight-bearing, adequate bone grafting and correction of deformity using rigid implants.
摘要
本研究的目的是探讨可扩张钛笼植入治疗急性椎体骨髓炎所致大的骨缺损的疗效。25例急性单节段或多节段脊椎椎间盘炎患者在进行根治性清创和后路内固定后，采用前路可扩张钛笼和植骨治疗。临床、实验室及影像学随访持续36个月。术后病程中无脊柱感染复发。最终影像学检查显示所有病例均成功融合，无植入物松动或失败。在36个月的最终随访中，奥斯威斯功能障碍指数为23±14，疼痛视觉模拟评分为2.1±1.7。本研究表明，所有患者在植入可扩张钛笼后均实现愈合且功能改善。实现最佳愈合的前提条件包括根治性清创、提供负重稳定性、充分植骨以及使用刚性植入物矫正畸形。
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