Li Tian-Qing, Ma Zhen-Sheng, Zhang Yang, Xu Hui-Fa, Lei Wei
Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China.
Medicine (Baltimore). 2019 Jun;98(23):e15941. doi: 10.1097/MD.0000000000015941.
Increasing number of studies have shown growing incidence of lumbosacral tuberculosis and its complications. However, the treatment options for this disorder are still limited.To evaluate the long-term therapeutic effect and prognosis of minimally invasive puncture catheter drainage and Isoniazid local chemotherapy for the treatment of lumbosacral tuberculosis without neural symptoms under the guidance of computed tomography (CT).A total of 45 patients with asymptomatic lumbosacral tuberculosis were treated by minimally invasive catheter drainage under CT guidance. Forty-two cases had been followed up, which included 22 women and 20 men with an average age of 36.45 years old. Isoniazid was injected locally and antituberculotic drugs were administered for postoperative treatment. Oswestry Disability Index (ODI), visual analogue scale (VAS) evaluation and Cobb angle were recorded before and after operation.Forty-two patients had been followed up and the follow-up term was from 1.2 to 8.5 years (average 60 months). All patients were healed without recurrent cases. The ODI were improved from 14.86 ± 2.02 before operation to 1.48 ± 1.55 after operation. The post-operative (4.19 ± 1.17) VAS score was improved compared to the pre-operative VAS score (0.55 ± 0.55). The post-operative Cobb angle (6.19° ± 3.85°) was also improved relatively to the preoperative Cobb angle (5.90° ± 3.71°).Minimally invasive puncture catheter drainage combined with Isoniazid local chemotherapy is an effective method for lumbosacral tuberculosis without neural symptom. Meanwhile, it can be applied for the treatment of spinal tuberculosis before open surgery.
越来越多的研究表明，腰骶部结核及其并发症的发病率在不断上升。然而，这种疾病的治疗选择仍然有限。为了评估在计算机断层扫描（CT）引导下，微创穿刺导管引流联合异烟肼局部化疗治疗无神经症状的腰骶部结核的长期治疗效果和预后。共有45例无症状腰骶部结核患者在CT引导下接受了微创导管引流治疗。其中42例进行了随访，包括22名女性和20名男性，平均年龄为36.45岁。术后局部注射异烟肼并给予抗结核药物治疗。记录术前和术后的Oswestry功能障碍指数（ODI）、视觉模拟评分（VAS）评估和Cobb角。42例患者进行了随访，随访时间为1.2至8.5年（平均60个月）。所有患者均治愈，无复发病例。ODI从术前的14.86±2.02改善至术后的1.48±1.55。术后VAS评分（4.19±1.17）较术前VAS评分（0.55±0.55）有所改善。术后Cobb角（6.19°±3.85°）较术前Cobb角（5.90°±3.71°）也有相对改善。微创穿刺导管引流联合异烟肼局部化疗是治疗无神经症状的腰骶部结核的有效方法。同时，它可在开放手术前应用于脊柱结核的治疗。
