Autologous iliac bone graft and plate fixation in the repair of tuberculosis of the thoracic vertebra
10.3969/j.issn.2095-4344.2014.35.006
- VernacularTitle:自体髂骨植骨与钢板置入内固定修复胸椎结核
- Author:
Jiang HUANG
;
Yuan YANG
;
Chunbo LIN
;
Xiaofeng LI
- Publication Type:Journal Article
- Keywords:
thoracic vertebrae;
tuberculosis;
internal fixators;
ilium;
bone transplantation
- From:
Chinese Journal of Tissue Engineering Research
2014;(35):5606-5610
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Thoracic vertebra connected to the corresponding section of the ribs constitute thoracic vertebral, which is deep, and the structure is complicated, so it is difficult to ful y expose thoracic vertebrae. Usual y, corresponding ribs is removed, and the injured site wil be reached through thoracic cavity. The trauma is big. Some complications often occur such as chest pain, and local skin numbness. Therefore, whether it is possible to reach the same target without removal of ribs through intercostal space became a new clinical problem. OBJECTIVE:To explore the safety and efficacy of autologous iliac bone graft and plate fixation for tuberculosis of thoracic vertebra. METHODS:A total of 30 patients diagnosed with tuberculosis of thoracic vertebra from January 2008 to December 2013 were conventional y treated with anti-tuberculosis treatment for 2 to 3 weeks, and then treated with autologous iliac bone fusion through intercostal space and anterior plate fixation. Postoperative fol ow-up was conducted from 6 to 22 months. Fracture healing condition, the degree of pain relief, Cobb angle change, length of incision, blood loss, operation time, postoperative recovery of neurological function were observed. RESULTS AND CONCLUSION:In 30 patients, the length of incision was (12.4±1.8) cm;longitudinal incision distraction width was (10±3.2) cm;the time of opening the chest was (16.0±2 .5) minutes;the time of closing the chest was (12.0±1.5) minutes;intraoperative blood loss amount was (430.0±87.4) mL. Preoperative and postoperative average kyphosis angles were respectively 27° and 8°, with an average rectification of 19°. The pain basical y relieved at 1 to 2 weeks after the surgery. 28 patients were healed, and the symptoms of 2 patients were improved. Postoperative fol ow-up radiographs revealed that autologous bone grafts were thoroughly fused, and the fusion time lasted from 4 to 5 months. These data verified that autologous iliac bone graft through intercostal space and plate fixation is an effective, safe method for tuberculosis of thoracic vertebra. The exposed range through intercostal space can satisfy the operation requirements of complete tuberculosis clearance, autologous iliac bone graft and plate fixation, and can ensure the integrity of the whole thorax and spine stability.
