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采用前路内固定和钛网融合器一期治疗颈椎骨髓炎

Single-stage Treatment of Osteomyelitis of the Cervical Spine Using Anterior Instrumentation and Titanium Mesh Cages.

作者信息

Zhang Zhen-Xing, Li Tao, Hao Ding-Jun

机构信息

Department of Spinal Surgery, Xi'an HongHui Hospital Affiliated to Xi'an JiaoTong University College of Medicine, Xi'an, Shaanxi, China.

出版信息

Spine (Phila Pa 1976). 2016 Aug 15;41(16):E949-E954. doi: 10.1097/BRS.0000000000001515.

Abstract

STUDY DESIGN

A case series.

OBJECTIVE

The aim of this study was to evaluate the clinical outcomes of patients with osteomyelitis of the cervical spine who were treated with single-stage anterior debridement and fusion using titanium mesh cages along with anterior plates.

SUMMARY OF BACKGROUND DATA

There have been few studies in single-stage surgical treatment of osteomyelitis of the cervical spine using titanium mesh cages along with anterior plates.

METHODS

Twenty-four patients treated for osteomyelitis of the cervical spine are presented. There were 11 male and 13 female with an average age of 53.3 years (42-63). Seventeen patients presented with a neurologic deficit at the time of diagnosis. Surgical treatment consisted of anterior debridement and fusion using titanium mesh cages along with anterior plates as a one-step procedure. The patients' records and radiographs were retrospectively analyzed and follow-up clinical and radiographic data obtained.

RESULTS

The median follow-up period was 52 months. There were no implant failures. All patients showed a solid bony fusion without any recurrence of infection at latest follow-up. Changes in pain level, hematologic parameters, and neurologic status demonstrated a significant clinical improvement in all patients.

CONCLUSION

This single-stage surgical treatment for osteomyelitis of the cervical spine provided satisfactory results. There is no increased risk of recurrence or persistence of infection related to the implantation of titanium mesh cages and instrumentation.

LEVEL OF EVIDENCE

摘要

研究设计

病例系列研究。

目的

本研究旨在评估采用钛网融合器联合前路钢板进行一期前路清创融合术治疗颈椎骨髓炎患者的临床疗效。

背景资料总结

关于采用钛网融合器联合前路钢板对颈椎骨髓炎进行一期手术治疗的研究较少。

方法

报告了24例接受颈椎骨髓炎治疗的患者。其中男性11例,女性13例,平均年龄53.3岁(42 - 63岁)。17例患者在诊断时伴有神经功能缺损。手术治疗包括采用钛网融合器联合前路钢板进行一期前路清创融合术。对患者的病历和X线片进行回顾性分析,并获取随访期的临床及影像学资料。

结果

中位随访期为52个月。无植入物失败情况。在最近一次随访时,所有患者均实现了牢固的骨融合,且无感染复发。疼痛程度、血液学参数及神经功能状态的变化表明所有患者均有显著的临床改善。

结论

这种颈椎骨髓炎的一期手术治疗取得了满意的效果。与钛网融合器植入及器械使用相关的感染复发或持续风险并未增加。

证据等级

4级。

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