中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (30): 5681-5685.doi: 10.3969/j.issn.2095-4344.2012.30.033

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

单纯后路双侧截骨并椎弓根钉置入矫形植骨融合内固定修复脊柱结核伴 严重后凸畸形的生物力学特点

陈 明1，赵劲民1，李 兵2，肖增明1，彭小忠2，苏 伟1，沙 轲1，武振国2，张 莹2   

  1. 1广西医科大学第一附属医院骨科，广西壮族自治区南宁市 530021；
    2广西医科大学第四附属医院骨科，广西壮族自治区柳州市 545005
  • 收稿日期:2011-11-14 修回日期:2011-12-15 出版日期:2012-07-22 发布日期:2012-07-22
  • 通讯作者: 赵劲民，教授，博士生导师，广西医科大学第一附属医院骨科，广西壮族自治区南宁市 530021 zhaojinmin@126.com

Biomechanical characteristics of posterior spine dual-plane osteotomy, debridement and fusion, pedicle screw fixation for spinal tuberculosis with severe kyphosis

Chen Ming1, Zhao Jin-min1, Li Bing2, Xiao Zeng-ming1, Peng Xiao-zhong2, Su Wei1, Sha Ke1, Wu Zhen-guo2, Zhang Ying2   

  1. 1Department of Orthopedics, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China;
    2Department of Orthopedics, the Forth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China
  • Received:2011-11-14 Revised:2011-12-15 Online:2012-07-22 Published:2012-07-22
  • Contact: Zhao Jin-min, Professor, Doctoral supervisor, Department of Orthopedics, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China zhaojinmin@126.com
  • About author:Chen Ming☆, Studying for doctorate, Attending physician, Department of Orthopedics, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China nxcnn@163.com Peng Xiao-zhong, Associate chief physician, Department of Orthopedics, the Forth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China Chen Ming and Peng Xiao-zhong contributed equally to this paper.

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410

被引次数

7

摘要：

背景：对于大于40°的脊柱结核畸形、脊髓或马尾、神经根受压及不稳定者行开放手术指征是明确的，经后路行切开病灶清除，植骨，矫形融合内固定是理想的治疗方法。
目的：分析后路脊椎双平面截骨矫形、病灶清除植骨融合、椎弓根钉置入内固定治疗脊柱结核伴严重后凸畸形的临床结果及其生物力学特点。
方法：回顾性分析2009-01/2010-01接受一期后路脊椎双侧截骨矫形、病灶清除植骨融合、椎弓根钉置入内固定治疗脊柱结核伴严重脊柱后凸畸形9例患者的临床资料。
结果与结论：9例均安全渡过围手术期，获随访12(8~16)个月，未见结核复发，均骨性融合，末次随访Cobb角及疼痛目测类比VAS评分均较治疗前明显改善(P < 0.01)，植骨融合时间8.5(5~14)个月。说明后路脊椎双平面截骨矫形、病灶清除植骨融合、椎弓根钉置入内固定治疗脊柱结核伴严重后凸畸形配合正确的抗痨治疗，可取得优良的临床疗效及生物力学效果。

关键词: 椎弓根钉, 脊柱结核, 后凸畸形, 截骨矫形, 内固定

Abstract:

BACKGROUND: It is effective in the application of posterior incision debridement, bone graft and fixation on the patients with spinal tuberculosis deformity angle more than 40°, spinal cord or cauda equina, nerve root compression and unstable.
OBJECTIVE: To analyze clinical results and biomechanical characteristics of the posterior spine dual-plane osteotomy, debridement and fusion, pedicle screw fixation for the patients of spinal tuberculosis with severe kyphosis.
METHODS: From January 2009 to January 2010, the clinical information of nine patients who accepted a bilateral posterior spinal osteotomy, debridement and fusion with pedicle screw fixation for the treatment of spinal tuberculosis with severe kyphosis was analyzed retrospectively.
RESULTS AND CONCLUSION: All the patients were safe in the perioperative period, the term of followed up was 12 (8-16) months, without the cases recurrence of tuberculosis and were all bone fusion, Cobb angle of the last follow-up and visual analogue scale score compared with preoperative score improved significantly (P < 0.01), fusion time was 8.5 (5-14) months. The clinical outcomes illustrated that the correct anti-tuberculosis treatment with the posterior spine dual-plane osteotomy, debridement and fusion, pedicle screw fixation for the treatment of spinal tuberculosis with severe kyphosis has better clinical and biomechanical effectiveness.

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