【摘 要】
：
目的 探讨一期后路短节段融合内固定、二期前路病灶清除椎间植骨治疗幼儿腰椎结核伴后凸畸形的手术方法和疗效.方法：2006年1月至2014年6月,我院共收治年龄小于7岁患有腰椎结核并后凸畸形的患儿共17例,其中男性9例,女性8例,年龄4-7岁,平均年龄5.1岁.术前节段后凸Cobb角为18-48°,平均24.18±7.15°.ASIA分级： C级4例,D级9例,E级4例.JOA评分术前14-27分,平
【机 构】
：
中南大学湘雅医院脊柱外科湘雅脊柱外科中心,长沙410008
【出 处】
：
第三届全国脊柱结核诊疗新技术研讨会暨2017年湖南省医学会脊柱外科专业委员会年会
论文部分内容阅读
目的 探讨一期后路短节段融合内固定、二期前路病灶清除椎间植骨治疗幼儿腰椎结核伴后凸畸形的手术方法和疗效.方法：2006年1月至2014年6月,我院共收治年龄小于7岁患有腰椎结核并后凸畸形的患儿共17例,其中男性9例,女性8例,年龄4-7岁,平均年龄5.1岁.术前节段后凸Cobb角为18-48°,平均24.18±7.15°.ASIA分级： C级4例,D级9例,E级4例.JOA评分术前14-27分,平均21.53±5.04分.均采用后路一期钉棒内固定植骨融合,前路二期病灶清除椎间植骨融合术治疗.观察比较患者术前术后及末次随访的节段后凸Cobb角变化,评估植骨融合情况及神经功能情况.结果：所有病例均获得随访,随访时间10-42个月.术前节段后凸Cobb角-3-11°,平均0.12±4.24°,较术前明显改善(P=0.000)；末次随访节段后凸Cobb角-2-9°,平均0.65±3.92°,较术前明显改善(P=0.000),与术后比较无明显差异(P=0.269).术后JOA评分27-29分,平均28.06±0.90分,与术前有明显差异(P=0.000).末次随访,ASIA分级：17例患者均恢复到E级.随访期间均未发现内固定的松动,脱出,移位,断裂.结论：对低龄儿童脊柱结核合并后凸畸形,采用后路短节段固定植骨融合合并二期前路病灶清除钛网植骨融合可以取得较好的疗效.
其他文献
Purpose Retrospective analysis of the clinical efficacy and feasibility of patients with thoracolumbar spinal tuberculosis with psoas abscesses treated by one-stage posterior transforaminal lumbar deb
Purpose Retrospective analysis of the clinical study effi-cacy and feasibility of one-stage posterior transforaminal lumbar debridement,360° interbody fusion,and posterior instrumentation in treating
Purpose To investigate the clinical efficacy and feasibil-ity of one-stage surgical treatment for thoracic spinal tuber-culosis with adjacent segments lesion by internal fixation,transpedicular debrid
Purpose To evaluate the clinical study efficacy and feasi-bility of 17 aged patients with lumbo-sacral tuberculosis treated by one-stage posterior transforaminal lumbar debridement,interbody fusion,an
Purpose To compare the clinical outcomes of surgical management by posterior only and combined posterior and anterior approaches for thoracic spinal tuberculosis in the elderly.Materials and methods T
Purpose We evaluated the clinical efficacy and feasibility of one-stage posterior internal fixation,debridement and interbody thoracic fusion in the treatment of thoracic tuberculosis.Methods Sixty ad
Purpose Various surgical methods have been described for the management of lumbar tuberculous spondylitis in the literature.However,there were few reports on the two-stage surgical treatment of lumbar
Purpose Multilevel noncontiguous thoracic spinal tuber-culosis has rarely been reported in the literature.We present a retrospective clinical study of 14 patients with multilevel noncontiguous thoraci
目的 探讨应用单纯经后路病灶清除椎体间植骨术治疗脊柱结核的可行性及安全性,观察并评估该术式的确切临床疗效.方法 回顾分析自2003年1月-2015年6月,我院采用手术治疗的单运动节段脊柱结核共1054例,其中采用前路术式329例,采用单纯经后路病灶清除椎体间植骨术725例.单纯经后路病灶清除椎体间植骨术组中,男375例,女350例；年龄3～84岁,平均38.3±9.54岁；其中胸段212例,胸腰段
Background: The standard recommended method for surgical treatment of spinal tuberculosis is an anterior approach for debridement and fusion combined with posterior instrumentation.However,the method