Chen Xue-Wu, Xu Hong-Guang, Liu Ping, Yang Xiao-Ming, Zhang Yu, Li Yi-Feng
Department of Spinal Surgery, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241001, Anhui, China.
Zhongguo Gu Shang. 2020 May 25;33(5):454-8. doi: 10.12200/j.issn.1003-0034.2020.02.013.
To evaluate the clinical outcomes of one-stage transpedicular debridement, posterior internal fixation, RBK mixed streptomycin filled bone grafting for the treatment of elderly patients with thoracolumbar tuberculosis.
The clinical data of 20 elderly patients with thoracolumbar tuberculosis underwent one stage transpedicular debridement, posterior internal fixation, OSTEOSET RBK mixed streptomycin-filled bone grafting from September 2006 to July 2017 were retrospectively analyzed. There were 12 males and 8 females, aged from 62 to 83 years with an average of (72.4±6.9) years old. Visual analogue scale (VAS), Oswestry Disability Index (ODI)were used to evaluate the pain and spinal function. The kyphosis angle (Cobb angle) of the lesion segment and the bone growth of the lesion area were observed by the X-ray films.
All the operations were successful, the operation time was (160.9±23.8) min, and the intraoperative blood loss was (317.9± 112.7) ml. The incisions were healed by first intention, and no sinus and incision were delayed. Spinal tuberculosis was completely cured, Frankel grade has one or more improvements. The VAS score decreased from (7.50±1.15) points before surgery to (1.70±1.39) points at 12 months after surgery (<0.05). The ODI score decreased from preoperative (92.50±1.17)% to (12.80±0.89)% at the final follow up (<0.05). The sagittal Cobb angle of the lesion segment decreased from preoperative (24.2±1.6)° to (8.3±0.7)°at 12 months after surgery(<0.05), the kyphosis deformity was significantly corrected. In all cases, bone fusion was achieved in bone graft area, without bone nonunion and device fracture complications.
One-stage transpedicular debridement, posterior internal fixation, RBK mixed streptomycin filled bone grafting is suitable for thoracolumbar tuberculosis patients with good general condition and less vertebral destruction.
评估一期经椎弓根清创、后路内固定、RBK混合链霉素填充植骨治疗老年胸腰椎结核患者的临床疗效。
回顾性分析2006年9月至2017年7月期间接受一期经椎弓根清创、后路内固定、OSTEOSET RBK混合链霉素填充植骨治疗的20例老年胸腰椎结核患者的临床资料。其中男性12例，女性8例，年龄62～83岁，平均（72.4±6.9）岁。采用视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）评估疼痛及脊柱功能。通过X线片观察病变节段的后凸角（Cobb角）及病变区域的骨质生长情况。
所有手术均获成功，手术时间为（160.9±23.8）分钟，术中出血量为（317.9±112.7）毫升。切口均一期愈合，无窦道及切口延迟愈合情况。脊柱结核均获治愈，Frankel分级有一级或以上改善。VAS评分由术前（7.50±1.15）分降至术后12个月时的（1.70±1.39）分（<0.05）。ODI评分由术前（92.50±1.17）%降至末次随访时的（12.80±0.89）%（<0.05）。病变节段矢状面Cobb角由术前（24.2±1.6）°降至术后12个月时的（8.3±0.7）°（<0.05），后凸畸形明显矫正。所有病例植骨区均获骨融合，无骨不连及内固定断裂并发症。
一期经椎弓根清创、后路内固定、RBK混合链霉素填充植骨适用于全身状况良好、椎体破坏较少的胸腰椎结核患者。
