Ran Bing, Xie Yuan-Long, Yan Lei, Cai Lin
Department of Orthopedics, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China.
J Huazhong Univ Sci Technolog Med Sci. 2016 Aug;36(4):541-547. doi: 10.1007/s11596-016-1622-7. Epub 2016 Jul 28.
This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose lesions were confined to adjacent segments were admitted to our hospital and treated. The American Spinal Injury Association (ASIA) impairment scale was used to assess the neurological function. All patients were treated with one-stage surgical treatment via a posterior-only approach. The clinical efficacy was evaluated by the Japanese Orthopaedic Association (JOA) scores and oswestry disability index (ODI) of nerve function. Patients were evaluated preoperatively and postoperatively by measurement of spinal deformity using Cobb angle and radiological examination. All the patients were followed up for 13 to 27 months. They had significantly postoperative improvement in JOA score, ODI and ASIA classification scores. The kyphotic angles were significantly corrected and maintained at the final follow-up. Bone fusion was achieved within 4-12 months. It was concluded that one-stage surgical treatment via a posterior-only approach is effective and feasible for the treatment of spinal tuberculosis.
本研究探讨了经单纯后路一期手术治疗脊柱结核患者的临床疗效。24例病变局限于相邻节段的胸腰椎脊柱结核患者入院接受治疗。采用美国脊髓损伤协会(ASIA)损伤分级评估神经功能。所有患者均采用单纯后路一期手术治疗。通过日本骨科协会(JOA)评分和神经功能Oswestry功能障碍指数(ODI)评估临床疗效。术前和术后通过Cobb角测量脊柱畸形及影像学检查对患者进行评估。所有患者均随访13至27个月。患者术后JOA评分、ODI及ASIA分级评分均有显著改善。后凸角得到显著矫正并在末次随访时得以维持。4至12个月内实现了骨融合。结论是,经单纯后路一期手术治疗脊柱结核有效且可行。