摘要
背景:脊柱结核累及颈椎的较少。抗结核药物的应用对于伴有神经功能障碍及椎体破坏较重出现椎间不稳的患者收效甚微。目的:评价一期前路病灶清除植骨融合内固定修复成人颈椎结核后技术植入物与宿主的生物相容性。方法:收集于2010年5月至2012年6月在新疆医科大学第一附属医院脊柱外科进行治疗的颈椎结核患者14例,均采用Zephir颈椎前路钢板进行一期前路病灶清除植骨融合内固定治疗。结果与结论:与内固定前相比,末次随访患者血沉、C-反应蛋白、目测类比评分下降(P<0.05),日本骨科协会评分增加(P<0.05)。除1例Frankel脊髓损伤分级C级患者恢复到D级外,其余患者Frankel脊髓损伤分级没有明显变化。与内固定前相比,7例伴后凸畸形患者的Cobb角明显缩小。且内固定后椎体与植骨区域可见骨小梁通过,融合节段无移位及骨吸收、骨不连、假关节形成等现象出现。内固定后颈部疼痛及功能受限均得到不同程度的缓解或消失。说明此方法能有效治疗颈椎结核,且钢板与宿主的生物相容性良好。
BACKGROUND： Spinal tuberculosis seldom involves cervical vertebra. The application of anti-tuberculosis drug has slight effects on patients combined with nerve dysfunction and severe vertebral destruction, which results in unstable cervical vertebra. OBJECTIVE： To evaluate biocompatibility of graft and host after one-stage anterior debridement graft fusion and internal fixation in the repair of adult cervical tuberculosis. METHODS： A total of 14 patients who suffered from cervical tuberculosis were admitted into Department of Spinal Surgery, First Affiliated Hospital, Xinjiang Medical University between May 2010 and June 2012. They underwent Zephir anterior cervical plate for one-stage anterior debridement graft fusion and internal fixation. RESULTS AND CONCLUSION： Compared with pre-fixation, erythrocyte sedimentation rate, C-reactive protein and visual analog scale score were lower in final follow-up（P〈0.05）, and Japanese Orthopaedic Association score increased（P〈0.05）. Except that Frankel grade recovered to grade D from grade C in one case, Frankel grade did not alter in the remaining patients. Compared with pre-fixation, Cobb angle was apparently shortened in seven patients with kyphosis. Following internal fixation, bone trabecula was visible between the vertebral body and graft region after fixation. No displacement, bone resorption, nonunion or pseudoarthrosis occurred. Neck pain and limited function relieved or disappeared to different degrees after fixation. These findings suggest this method can effectively treat cervical tuberculosis. Moreover, the biocompatibility of the plate and host is good.
出处
《中国组织工程研究》
CAS
北大核心
2015年第22期3508-3512,共5页
Chinese Journal of Tissue Engineering Research
