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目的 :对胸椎结核合并截瘫者进行病灶清除。方法 :采用经胸病灶清除椎管前方减压加大块髂骨移植治疗胸椎结核合并截瘫 43例 ,结果 :术后截瘫完全恢复 40例 (93% )。作者认为经胸病灶清除椎管前方减压能充分暴露病灶 ,达到彻底清除结核病灶 ,有效的椎管减压要求。病灶清除后 ,椎体间缺损大于 3cm者 ,采用大块全板髂骨作椎体间植骨。全部病人在术后 2年摄片复查 ,发现植骨块位置良好 ,髂骨块与植骨床融合。结论 :大块全板髂骨作椎体间植骨抗折、抗弯曲能力强 ,有固定可靠 ,植骨融合率高等优点。
Objective: Thoracic tuberculosis complicated with paraplegia were cleared. Methods: Forty-three patients with thoracic tuberculosis complicated with paraplegia were treated with transcatheter debridement of anterior canal decompression and massive iliac bone graft. Results: Complete recovery of paraplegia was achieved in 40 (93%) patients. The authors believe that transthoracic lesions clear the anterior decompression can fully expose the lesion to achieve complete removal of tuberculosis, effective spinal decompression requirements. After the lesion was cleared, the vertebral body defect was more than 3cm, using a large lumbar intervertebral bone graft. All patients 2 years after radiography review, found that bone graft in good position, iliac bone graft and bone fusion. CONCLUSION: The lumbar intervertebral bone graft is a large, full-thickness iliac bone graft with good anti-bending ability, reliable fixation and high fusion rate.