胸腰椎脊柱结核的外科治疗研究进展
[Research progress of surgical treatment of thoracolumbar spinal tuberculosis].
作者信息
Gao Yongjian, Ou Yunsheng, Quan Zhengxue, Jiang Dianming
机构信息
Department of Orthopedics, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, P.R.China.
Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010,
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Jan 15;32(1):112-117. doi: 10.7507/1002-1892.201705124.
OBJECTIVE
To review the progress of surgical treatment for the thoracolumbar spinal tuberculosis.
METHODS
The related literature of surgical treatment for the thoracolumbar spinal tuberculosis was reviewed and analyzed from the aspects such as surgical approach, fixed segments, fusion ranges, bone graft, and bone graft material research progress.
RESULTS
Most scholars prefer anterior or combined posterior approach for surgical treatment of thoracic and lumbar tuberculosis because it possessed advantage of precise effectiveness. In recent years, a simple posterior surgery achieved satisfactory effectiveness. The fixation segments are mainly composed of short segments or intervertebral fixation. The interbody fusion is better for the bone graft fusion range and manner, and the bone graft materials is most satisfied with autologous iliac Cage or titanium Cage filled with autologous cancellous bone.
CONCLUSION
The perfect strategy for treating the thoracolumbar spinal tuberculosis has not yet been developed, and the personalized therapy for different patients warrants further study.
目的
回顾胸腰椎脊柱结核的外科治疗进展。
方法
从手术入路、固定节段、融合范围、植骨及植骨材料研究进展等方面，对胸腰椎脊柱结核外科治疗的相关文献进行回顾与分析。
结果
大多数学者倾向于采用前路或前后联合入路手术治疗胸腰椎结核，因其具有确切有效的优势。近年来，单纯后路手术也取得了满意疗效。固定节段主要为短节段或椎间固定。椎间融合在植骨融合范围及方式上更佳，植骨材料以自体髂骨Cage或填充自体松质骨的钛Cage最为满意。
结论
治疗胸腰椎脊柱结核的完美策略尚未形成，针对不同患者的个体化治疗有待进一步研究。
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