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腰骶部结核的前路与后路手术入路

Anterior versus posterior surgical approach for lumbosacral tuberculosis.

作者信息

Zheng Bolong, Hao Dingjun, Guo Hua, He Baorong

机构信息

Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shanxi, China.

出版信息

J Int Med Res. 2018 Jul;46(7):2569-2577. doi: 10.1177/0300060518764933. Epub 2018 Mar 27.

Abstract

Objective To compare two different approaches for the treatment of lumbosacral tuberculosis. Patients and Methods In total, 115 patients who were surgically treated in our department from July 2010 to July 2014 were included in this retrospective study. They were divided into the anterior and posterior approach groups. Intraoperative hemorrhage; the surgery time; the Cobb angle preoperatively, postoperatively, and at the follow-up visit (2 years postoperatively); visual analog scale (VAS) pain scores before and after surgery; and Oswestry Disability Index (ODI) scores before and after surgery were compared between the two groups. Results The Cobb angle and VAS and ODI scores were significantly improved in both groups after surgery. Significant differences were found in the operation time, intraoperative hemorrhage, Cobb angle correction, and loss of correction at the last follow-up. No significant differences were found in the VAS and ODI scores between the groups. Conclusions The posterior approach is superior to the anterior approach with respect to the surgery time, intraoperative hemorrhage, and Cobb angle postoperatively and at the last follow-up. When both approaches can be carried out for a patient with lumbosacral tuberculosis, the posterior approach should be favored over the anterior approach.

摘要

目的 比较两种不同的腰骶部结核治疗方法。患者与方法 本回顾性研究纳入了2010年7月至2014年7月在我科接受手术治疗的115例患者。他们被分为前路组和后路组。比较两组的术中出血量、手术时间、术前、术后及随访(术后2年)时的Cobb角、手术前后的视觉模拟评分(VAS)疼痛评分以及手术前后的Oswestry功能障碍指数(ODI)评分。结果 两组术后Cobb角、VAS和ODI评分均显著改善。在手术时间、术中出血量、Cobb角矫正及末次随访时的矫正丢失方面发现有显著差异。两组间VAS和ODI评分未发现显著差异。结论 后路手术在手术时间、术中出血量以及术后和末次随访时的Cobb角方面优于前路手术。当腰骶部结核患者两种手术方式均可实施时,应优先选择后路手术而非前路手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe34/6124266/836778949ce8/10.1177_0300060518764933-fig1.jpg

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