Department of Orthopaedics, Southwest Hospital, Chongqing, 400038, China.
Department of Orthopaedics, Xi'an Honghui Hospital, Xi'an, China.
Sci Rep. 2020 Aug 3;10(1):13037. doi: 10.1038/s41598-020-70007-z.
To assess the effectiveness of tricortical iliac crest allografts with anterolateral instrumentation after single-stage surgery for thoracic and lumbar spinal tuberculosis (TB). Fifty-six patients with thoracic and lumbar spinal TB underwent single-stage anterior radical debridement, interbody fusion with tricortical iliac crest allografts and anterolateral single rod instrumentation. All patients were given 18 months of antituberculosis chemotherapy. The patients were followed up regularly, and their clinical manifestations, roentgenogram results, erythrocyte sedimentation rate (ESR) and liver function test were the results to be concerned. Radiographs were analysed before surgery, immediately after surgery, and at the final follow-up examination. Mean follow-up period was 37.5 months in 52 patients, and 4 patients were lost to follow-up. No patients had superficial wound infections, and all the incisions healed within 2 weeks. No graft fracture, collapse, or sliding was observed. The average bony fusion time was 10.6 months. Bony fusion was observed in all 52 patients within 18 months. The average degrees of kyphotic correction loss for thoracic and lumbar spine were 6.71° and 2.78° respectively. Although it took a long time to achieve solid fusion, tricortical iliac crest allografts were found to be convenient and safe to be used in spinal TB surgery. They may be effective options for interbody fusion, deformity correction and correction maintenance with anterolateral single rod instrumentation.
评估单阶段手术治疗胸腰椎结核(TB)后路侧前方内固定联合同种异体三皮质髂骨植骨的效果。56 例胸腰椎结核患者行一期前路病灶彻底清除、同种异体三皮质髂骨植骨椎间融合及后路单棒内固定术。所有患者均接受 18 个月的抗结核化疗。定期随访患者,观察其临床表现、影像学结果、红细胞沉降率(ESR)和肝功能试验结果。术前、术后即刻和最终随访时进行影像学分析。52 例患者的平均随访时间为 37.5 个月,4 例患者失访。无患者发生浅表伤口感染,所有切口均在 2 周内愈合。无植骨骨折、塌陷或滑动。平均骨性融合时间为 10.6 个月。所有 52 例患者在 18 个月内均实现骨性融合。胸腰椎后凸畸形平均矫正丢失角度分别为 6.71°和 2.78°。尽管达到骨性融合需要很长时间,但同种异体三皮质髂骨植骨在脊柱结核手术中被发现是方便且安全的。对于后路单棒内固定的椎间融合、畸形矫正和矫正维持,它们可能是有效的选择。