关键词: 结核, 脊柱/外科学, 羟基磷灰石类, 骨黏合剂, 抗结核药, 钛, 内固定器, 脊柱融合术

Abstract: Objective To investigate the clinical application value of a new type of hydroxyapatite bone cement composite anti tuberculosis (TB) drugs and titanium mesh internal fixation for treatment of patients with spinal TB.  Methods Fifty patients with spinal TB who were treated by using the new hydroxyapatite bone cement composite anti-TB drugs and titanium mesh internal fixation at Jilin Provincial TB Hospital from January 2011 to January 2014 were enrolled in our study. Among those patients, 23 cases were male and 27 cases were female; the tuberculous lesions were located in the thoracic spine in 28 cases and lumbar spine in 22 cases; according to the USA Spinal Injury Association (ASIA) Classification, preoperative neurological function was Grade A in 1 patient, Grade B in 1 patient, Grade C in 6 patients, Grade D in 9 patients and Grade E in 33 patients. Before surgical operation, all those patients received anti-TB chemotherapy with the treatment regimen 3HRZE/9-15HRE for 2 weeks; the postoperative evaluations were done at the second week after patients received operations and every three months after patients were discharged from the hospital, and the evaluation was based on imaging examination results, clinical symptoms, intervertebral fusion, spinal deformity degree and neurological classification, etc.  Results All patients were followed up for mean (20±8) months (12-36 months). There were no postoperative deaths, no serious da-mages of spinal nerves, large blood vessels and important organs, no complications. Vertebral pain disappeared in all patients and the excellent and good rate of intervertebral fusion (Level Ⅰ±Level Ⅱ) was 94.0%(47/50), kyphosis instant correction was a mean (20±0.7) degrees and the average loss was (1.2±0.3) degrees in the last follow-up while the average loss was (0.5±0.2) degrees after internal fixation removal. The ASIA Classification was Grade E in all 50 patients after operations. All patients could walk in 1-2 weeks after operations. In total, the cure rate was 100.0% (50/50).  Conclusion The new hydroxyapatite bone cement composite anti-TB drugs and titanium mesh internal fixation has been confirmed by our study to be an effective method for treatment of patients with spinal TB and make patients rapid postoperative recovery.

Key words: Tuberculosis, spinal/surgery, Hydroxyapatites, Bone cements, Antitubercular agents, Titanium, Internal fixators, Spinal fusion