同种异体骨移植联合内固定治疗脊柱结核

被引:8
作者
张泽华
许建中
谭祖键
周强
机构
[1] 第三军医大学西南医院骨科
[2] 第三军医大学西南医院骨科 重庆
[3] 重庆
关键词
脊柱结核; 同种异体骨; 内固定器; 移植;
D O I
暂无
中图分类号
R687 [矫形外科手术学];
学科分类号
1002 ; 100210 ;
摘要
目的探讨病灶彻底清除后同种异体髂骨块移植联合内固定治疗脊柱结核的可行性和安全性。方法对36例彻底清除脊柱结核病灶后,植入带三面皮质骨的异体髂骨块重建前柱,根据情况选择前方或侧前方内固定,术后支具保护6个月,正规抗结核化疗12个月。根据术前、术后及最后一次随访的X线平片分析融合情况和畸形矫正的进展。结果随访5~72个月,平均16个月,结核病灶均无复发,内固定牢靠无松动。19例患者椎间植骨均获I级骨性愈合,愈合时间9~12个月,5例患者获II级骨性愈合,其余患者待进一步随访观察;术前、术后及最后一次随访Cobb角分别为36.8°,17.2°,20.6°。结论尽管异体髂骨块移植达到骨性愈合的时间比用自体骨相对较长,但当与前路内固定器械结合应用时,可有效治疗及控制结核病变复发,维持畸形的矫正,使脊柱拥有良好的稳定性,经初步临床观察疗效满意。
引用
收藏
页码:154 / 157
页数:4
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