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一期后路清创植骨内固定治疗单节段胸腰椎结核的疗效

Efficacy of One-Stage Posterior Debridement and Bone Grafting with Internal Fixation in the Treatment of Monosegmental Thoracolumbar Tuberculosis.

作者信息

Li Zhao-Wei, Li Ze-Qing, Tang Bao-Ming, Ren Rong, Zhang Yuan, Li Chun-Liang, Zhang Xue-Bin

机构信息

Department of Trauma Orthopedics, Qinghai University Affiliated Hospital, Xining, People's Republic of China.

Department of Trauma Orthopedics, Qinghai Provincial People's Hospital, Xining, People's Republic of China.

出版信息

World Neurosurg. 2019 Jan;121:e843-e851. doi: 10.1016/j.wneu.2018.09.234. Epub 2018 Oct 9.

Abstract

BACKGROUND

We explored the clinical effect of one-stage posterior debridement and bone grafting with internal fixation for the treatment of monosegmental thoracolumbar tuberculosis (TB).

METHODS

The data from 90 patients with thoracolumbar TB, who had undergone one-stage posterior debridement and bone grafting with internal fixation, were retrospectively reviewed. Data on the operative time, blood loss, length of hospital stay, erythrocyte sedimentation rate, C-reactive protein, improvement of neurological function, visual analog scale score, vertebral Cobb angle, bone healing, and complications were collected.

RESULTS

A total of 88 patients were finally included in the present retrospective study, included 42 men and 46 women. The mean patient age was 45.4 ± 12.3 years (range, 27-70), and the mean duration of disease until treatment was 11 ± 4.5 months (range, 3-19). The mean operative time was 167.0 minutes (range, 130-210), and the mean blood loss was 767.4 mL (range, 500-1150). At the final follow-up examination, the correction in the Cobb angle was 19°, the visual analog scale score had decreased to 3 ± 1.72, the neurologic deficits using the Frankel grade had improved, and the erythrocyte sedimentation rate and C-reactive protein level had returned to normal levels.

CONCLUSION

One-stage posterior debridement and bone grafting with internal fixation might be a better choice for treating patients with monosegment thoracolumbar TB.

摘要

背景

我们探讨了一期后路清创植骨内固定治疗单节段胸腰椎结核(TB)的临床效果。

方法

回顾性分析90例行一期后路清创植骨内固定的胸腰椎结核患者的数据。收集手术时间、失血量、住院时间、红细胞沉降率、C反应蛋白、神经功能改善情况、视觉模拟评分、椎体Cobb角、骨愈合情况及并发症等数据。

结果

本回顾性研究最终纳入88例患者,其中男性42例,女性46例。患者平均年龄为45.4±12.3岁(范围27 - 70岁),治疗前平均病程为11±4.5个月(范围3 - 19个月)。平均手术时间为167.0分钟(范围130 - 210分钟),平均失血量为767.4毫升(范围500 - 1150毫升)。末次随访时,Cobb角矫正19°,视觉模拟评分降至3±1.72,Frankel分级的神经功能缺损有所改善,红细胞沉降率和C反应蛋白水平恢复正常。

结论

一期后路清创植骨内固定可能是治疗单节段胸腰椎结核患者的较好选择。

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