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经后路采用经椎弓根固定、清创、椎间融合与后路融合相结合的方法对胸腰椎脊柱结核进行一期手术治疗。

One-stage surgical treatment for thoracic and lumbar Spinal tuberculosis by transpedicular fixation, debridement, and combined interbody and posterior fusion via a posterior-only approach.

作者信息

Ran Bing, Xie Yuan-Long, Yan Lei, Cai Lin

机构信息

Department of Orthopedics, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China.

出版信息

J Huazhong Univ Sci Technolog Med Sci. 2016 Aug;36(4):541-547. doi: 10.1007/s11596-016-1622-7. Epub 2016 Jul 28.

DOI:10.1007/s11596-016-1622-7
PMID:27465330
Abstract

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.

摘要

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。

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One-stage surgical treatment for thoracic and lumbar Spinal tuberculosis by transpedicular fixation, debridement, and combined interbody and posterior fusion via a posterior-only approach.经后路采用经椎弓根固定、清创、椎间融合与后路融合相结合的方法对胸腰椎脊柱结核进行一期手术治疗。
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本文引用的文献

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Surgical treatment for spinal tuberculosis with bilateral paraspinal abscess or bilateral psoas abscess: one-stage surgery.双侧椎旁脓肿或双侧腰大肌脓肿的脊柱结核手术治疗:一期手术。
J Spinal Disord Tech. 2014 Dec;27(8):E309-14. doi: 10.1097/BSD.0000000000000120.
2
One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of lumbar spinal tuberculosis: a retrospective case series.一期后路清创、经椎间孔腰椎体间融合及内固定治疗腰椎脊柱结核:回顾性病例系列研究。
Arch Orthop Trauma Surg. 2013 Mar;133(3):333-41. doi: 10.1007/s00402-012-1669-2. Epub 2012 Dec 16.
3
One-stage surgical treatment for upper thoracic spinal tuberculosis by internal fixation, debridement, and combined interbody and posterior fusion via posterior-only approach.
钛网同种异体骨在单纯后路手术治疗胸段及胸腰段脊柱结核中的疗效
BMC Surg. 2020 Jun 12;20(1):133. doi: 10.1186/s12893-020-00793-w.
4
Initial stability of one-stage anterior debridement and cage implantation combined with anterior-lateral fixation by a dual screw-rod construct in the treatment of lumbosacral tuberculosis: a cadaveric biomechanical study.一期前路清创植骨融合联合双钉棒系统前路侧方固定治疗腰骶段结核的初始稳定性:尸体生物力学研究。
BMC Musculoskelet Disord. 2019 May 10;20(1):206. doi: 10.1186/s12891-019-2592-2.
5
Video-assisted thoracoscopic surgery for the treatment of mediastinal lymph node tuberculous abscesses.电视辅助胸腔镜手术治疗纵隔淋巴结结核脓肿
J Huazhong Univ Sci Technolog Med Sci. 2017 Dec;37(6):849-854. doi: 10.1007/s11596-017-1816-7. Epub 2017 Dec 21.
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Medicine (Baltimore). 2017 Jun;96(26):e7103. doi: 10.1097/MD.0000000000007103.
一期后路内固定、清创及后路椎间植骨融合术治疗胸上段脊柱结核
Eur Spine J. 2013 Mar;22(3):616-23. doi: 10.1007/s00586-012-2470-1. Epub 2012 Aug 18.
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