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目的 探讨多椎体结核内固定与非内固定疗效的差异 ,比较二者的优缺点。方法 总结 1990年～ 2 0 0 1年采用脊柱前路病灶清除植骨术与同时用饶氏椎体钉、Ventrofix、Z -Plate钢板、USS等器械内固定治疗胸腰椎结核病人共 12 4例。其中非内固定 6 8例 ,内固定 5 6例。观察术后植骨融合、神经恢复、畸形纠正情况及治愈率。结果 经平均 2 5年的随访证实 ,内固定植骨融合速度快于非内固定组 ,有显著性差异 ;神经功能Frankel分级二组全部得到改善 ;畸形纠正内固定组后弓角较术前平均改进 2 9°、非内固定组平均改进 5°,有显著性差异。内固定组治愈率为 10 0 % ,非内固定组治愈率为 87% ,有显著性差异。结论 脊柱结核内固定可早期重建脊柱稳定性并加速植骨融合 ;有明显改善畸形的作用 ;减少结核复发 ,在治疗多椎体结核中有重要意义
Objective To investigate the difference of efficacy between internal fixation and non-internal fixation of multi-vertebral tuberculosis, and to compare the advantages and disadvantages of both. Methods From 1990 to 2001, 12 cases of thoracolumbar tuberculosis patients were treated with debridement and anterior spinal debridement and spondylolisthesis, Ventrofix, Z-Plate and USS instrumentation. Among them, 68 cases were non-internal fixation and 56 cases were internal fixation. Postoperative bone graft fusion, nerve recovery, deformity correction and cure rate were observed. Results After an average of 25 years of follow-up, there was a significant difference in the fusion rate of internal fixation versus non-internal fixation group. All the Frankel grading of the neurological function group were improved. Improved 29 °, non-internal fixation group average improvement of 5 °, a significant difference. The cure rate of internal fixation group was 100%, and that of non-internal fixation group was 87%. There was a significant difference. Conclusion Internal fixation of spinal tuberculosis can reconstruct the spinal stability early and accelerate the fusion of bone and spine. It can significantly improve the deformity and reduce the recurrence of tuberculosis, which is of great significance in the treatment of multi-vertebral tuberculosis