Li Jianhua, Huang Xuequan, Chen Feifan, Dai Fei, Zhou Qiang, Luo Fei, Xu Jianzhong, Zhang Zehua
Orthopedics. 2017 May 1;40(3):e443-e449. doi: 10.3928/01477447-20170117-02. Epub 2017 Jan 23.
The goal of this study was to investigate the effect of individualized chemotherapy delivered via percutaneous catheter drainage on paravertebral abscesses in spinal tuberculosis (TB). Data from 48 patients with spinal TB with paravertebral abscesses who received individualized chemotherapy via computed tomography-guided catheterization between 2009 and 2012 were retrospectively analyzed. The paravertebral abscesses affected the thoracic vertebra (n=12), the lumbar spine (n=20), the thoracolumbar vertebra (n=10), and the lumbosacral (n=6). All patients achieved clinical healing with no recurrence. Erythrocyte sedimentation rate and visual analog scale scores decreased significantly by the endpoint of follow-up. Although C-reactive protein values increased slightly right after treatment, they were also significantly lower at last follow-up. The kyphotic angle and Oswestry Disability Index values also exhibited significant decreases. No neurologic function impairment was reported. Computed tomography-guided catheterization for continuous administration of individualized chemotherapy was a safe and effective treatment for spinal TB with paravertebral abscesses in the cohort examined, and thus, it warrants further study. [Orthopedics. 2017; 40(3):e443-e449.].
本研究的目的是探讨经皮导管引流进行个体化化疗对脊柱结核(TB)椎旁脓肿的影响。回顾性分析了2009年至2012年间48例经计算机断层扫描引导下置管接受个体化化疗的脊柱结核伴椎旁脓肿患者的数据。椎旁脓肿累及胸椎(n = 12)、腰椎(n = 20)、胸腰椎(n = 10)和腰骶部(n = 6)。所有患者均实现临床愈合且无复发。随访结束时,红细胞沉降率和视觉模拟评分显著降低。虽然治疗后C反应蛋白值略有升高,但在末次随访时也显著降低。后凸角和奥斯维斯特里功能障碍指数值也显著下降。未报告神经功能损害。在本研究队列中,计算机断层扫描引导下置管持续给予个体化化疗是治疗脊柱结核伴椎旁脓肿的一种安全有效的方法,因此值得进一步研究。[《骨科》。2017;40(3):e443 - e449。]