Tricortical iliac crest allograft with anterolateral single rod screw instrumentation in the treatment of thoracic and lumbar spinal tuberculosis
Tricortical iliac crest allograft with anterolateral single rod screw instrumentation in the treatment of thoracic and lumbar spinal tuberculosis
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前外侧单杆螺钉同种异体三皮质髂嵴移植治疗胸腰椎结核
DOI：
10.1038/s41598-020-70007-z
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发表时间：
2020-08-03
影响因子：
4.6
通讯作者：
Zhang, Zehua
中科院分区：
文献类型：
--
作者：
Zeng, Yanping;Fan, Yong;Zhang, Zehua
评估胸腰椎结核（TB）一期手术后采用三皮质髂嵴同种异体移植物联合前外侧内固定的有效性。五十六例胸腰椎结核患者接受了一期前路根治性清创术、三皮质髂嵴同种异体移植物椎间融合术和前外侧单棒内固定术。所有患者均给予18个月的抗结核化疗。定期随访，重点关注患者的临床表现、X线检查、血沉（ESR）及肝功能检查结果。在术前、术后即刻和最终随访检查时分析X线片。52例患者的平均随访时间为37.5个月，4例患者失访。所有患者均未发生浅表伤口感染，所有切口均在2周内愈合。未观察到移植物断裂、塌陷或滑动。平均骨性融合时间为10.6个月。所有52例患者在18个月内均观察到骨融合。胸椎和腰椎后凸矫正丢失的平均度数分别为6.71度和2.78度。虽然需要很长时间才能实现牢固融合，但发现三皮质髂嵴同种异体移植物用于脊柱结核手术是方便和安全的。它们可能是前外侧单棒内固定椎间融合、畸形矫正和矫正维持的有效选择。
To assess the effectiveness of tricortical iliac crest allografts with anterolateral instrumentation after single-stage surgery for thoracic and lumbar spinal tuberculosis (TB). Fifty-six patients with thoracic and lumbar spinal TB underwent single-stage anterior radical debridement, interbody fusion with tricortical iliac crest allografts and anterolateral single rod instrumentation. All patients were given 18 months of antituberculosis chemotherapy. The patients were followed up regularly, and their clinical manifestations, roentgenogram results, erythrocyte sedimentation rate (ESR) and liver function test were the results to be concerned. Radiographs were analysed before surgery, immediately after surgery, and at the final follow-up examination. Mean follow-up period was 37.5 months in 52 patients, and 4 patients were lost to follow-up. No patients had superficial wound infections, and all the incisions healed within 2 weeks. No graft fracture, collapse, or sliding was observed. The average bony fusion time was 10.6 months. Bony fusion was observed in all 52 patients within 18 months. The average degrees of kyphotic correction loss for thoracic and lumbar spine were 6.71 degrees and 2.78 degrees respectively. Although it took a long time to achieve solid fusion, tricortical iliac crest allografts were found to be convenient and safe to be used in spinal TB surgery. They may be effective options for interbody fusion, deformity correction and correction maintenance with anterolateral single rod instrumentation.