腰骶部结核手术治疗中不同后路远端固定方式的应用
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郑州市骨科医院

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Application of different posterior distal fixation systems in the surgical treatment of lumbosacral tuberculosis
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Zhengzhou Orthopaedics Hospital

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    摘要:

    [目的]分析手术治疗腰骶部结核时不同后路远端固定方式的优缺点。[方法]收集2018.03-2022.02郑州市骨科医院手术治疗腰骶部结核病例共12例的临床资料,进行回顾性分析。单纯后路病灶清除植骨融合内固定7例,前路病灶清除植骨融合加后路固定5例。7例远端仅固定至S1;4例固定至S2,S2侧块螺钉2例,S2AI螺钉2例;1例采用了髂骨钉固定。[结果]所有病例均有完整随访资料,9例患者预后良好。3例患者预后不佳,内固定失效,植骨未融合,其中2例为单纯后路手术,远端固定至S1的病例,1例为前后路联合病例,远端固定方式为单枚髂骨钉。[结论]坚强内固定是保证腰骶部结核手术治疗疗效的重要环节,合理选择固定方式十分重要。

    Abstract:

    [Objective] to analyze the advantages and disadvantages of different posterior distal fixation systems in the surgical treatment of lumbosacral tuberculosis. [Methods] from March 2018 to February 2022, the clinical data of 12 patients with lumbosacral tuberculosis who underwent surgical treatment in Zhengzhou Orthopaedic Hospital were collected and analyzed retrospectively. Posterior debridement, bone graft and internal fixation were performed in 7 cases;anterior debridement, bone graft and posterior internal fixation in 5 cases. Distal fixation only reached to S1 in 7 cases;4 cases to S2,2 cases used S2 lateral mass screws, 2 cases used S2AI screws; 1 case used ilium screws. [Results]all patients had complete follow-up data, 9 patients had good prognosis and 3 patients had poor prognosis. internal fixation failure and non-fusion occurred in the 3 cases. Among them, 2 cases were treated by posterior operation and distal fixation to S1,1 case was treated by combined anterior and posterior approaches and distal fixation was a single iliac screw. [Conclusion]rigid internal fixation is an important aspect to ensure the curative effect of lumbosacral tuberculosis, and it is very important to choose the reasonable fixation system.

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  • 收稿日期:2022-08-16
  • 最后修改日期:2022-08-22
  • 录用日期:2022-11-08
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