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目的 探讨治疗脊柱结核一期完成病灶清除、矫正脊柱后凸畸形、前后同时植骨融合的效果。方法 俯卧位 ,以病椎为中心作后正中切口 ,从病椎左右椎弓根骨膜下分离病灶 (在胸椎段 ,先切取左右肋骨后段 ) ,椎弓根短节段固定器 (RF系统 )矫正脊柱后凸畸形和椎体间高度 ,彻底清除结核病灶 ,前后同时植骨。结果 15例患者结核病灶清除彻底 ,脊柱畸形矫正角由术前 18°～ 45°矫正到术后 3 4° ,椎体间高度由术前 62 6 %恢复到术后 98 2 % ,植骨块无移位。结论 该手术入路简捷 ,病灶清除彻底 ,畸形矫正满意 ,三柱固定植骨融合 ,后期脊柱稳定 ,缩短了卧床时间 ,减少了相应的并发症。
Objective To investigate the effect of treating the first stage of spinal tuberculosis to complete the lesion, correct the kyphosis, and combine bone graft and anterior and posterior. Methods The prone position was made with the center of the diseased vertebrae as the center. The lesion was separated from the pedicle of the left and right vertebral pedicles (in the thoracic segment, the posterior segments of the left and right ribs were cut first), the pedicle short segment fixator (RF system) Correction of kyphosis and vertebral height, complete removal of tuberculosis, bone graft at the same time. Results The complete removal of tuberculosis in 15 patients was corrected from 18 ° ~ 45 ° before operation to 34 ° after operation. The height of the vertebral body was restored from 62.6% before operation to 98.2% after operation. No shift. Conclusion The surgical approach is simple, complete removal of the lesion, satisfactory correction of deformity, three-column fixation and fusion of bone graft, stabilization of the posterior spine, shortening the time in bed and reducing the corresponding complications.