Long Weihong, Gong Liqun, Cui Yaqing, Qi Jie, Duan Dapeng, Li Weiwei
Department of Orthopedic, Shaanxi Provincial People's Hospital, Xi'an, 710068, Shaanxi, China.
BMC Musculoskelet Disord. 2020 Sep 10;21(1):606. doi: 10.1186/s12891-020-03628-0.
Patients with continuous multi-vertebral lumbar spine tuberculosis (CMLSTB) were subjected to single posterior debridement, interbody fusion, and fixation to explore their clinical outcomes.
Sixty-seven CMLSTB patients who underwent single posterior debridement interbody fusion and fixation between January 2008 to December 2017 were studied. The operation time, blood loss, perioperative complication rate, cure rate, Visual Analog Scale (VAS), Oswetry disability index (ODI), Japanese Orthopedic Association (JOA), Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb's angle and time of interbody fusion were analyzed to understand their therapeutic effects on CMLSTB patients.
The patients were followed up for 20-48 months, with a mean of 24.3 months. The mean operation time was 215.5 min (range, 120-280 min), whereas 818.0 ml of blood was lost (range, 400-1500 ml) with a perioperative complication rate of 6.0% and a cure rate of 95.5%. During the last phase of follow-up, the mean preoperative VAS score (5.7) and ODI (72.0%) decreased significantly to 1.4 (t = 31.4, P<0.01) and 8.4% (t = 48.4, P<0.01), respectively. Alternatively, the mean preoperative ESR and CRP (74.7 mm /h and 69.3 mg/L, respectively) decreased to average values (t = 39.7, P<0.001; t = 50.2, P<0.001), while the JOA score (13.9) significantly increased to 23.0 (t = - 11.6, P<0.01). The preoperative kyphotic Cobb's angle (20.5°) decreased to 4.8° after the operation (t = 14.0, P<0.01); however, the kyphotic correction remained intact at the time of follow-up (t = - 0.476, P = 0.635). Furthermore, the mean of interbody fusion time was identified to be 8.8 months (range, 6-16 months).
Single posterior debridement, interbody fusion, and fixation may be one of the surgical choices for the treatment of CMLSTB patients.
对连续性多节段腰椎结核（CMLSTB）患者进行单纯后路病灶清除、椎间融合及内固定术，以探讨其临床疗效。
研究2008年1月至2017年12月期间接受单纯后路病灶清除椎间融合及内固定术的67例CMLSTB患者。分析手术时间、出血量、围手术期并发症发生率、治愈率、视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、日本骨科学会（JOA）评分、红细胞沉降率（ESR）、C反应蛋白（CRP）、后凸Cobb角及椎间融合时间，以了解其对CMLSTB患者的治疗效果。
患者随访20 - 48个月，平均24.3个月。平均手术时间为215.5分钟（范围120 - 280分钟），术中出血量818.0毫升（范围400 - 1500毫升），围手术期并发症发生率为6.0%，治愈率为95.5%。在末次随访时，术前平均VAS评分（5.7分）和ODI（72.0%）分别显著降至1.4分（t = 31.4，P < 0.01）和8.4%（t = 48.4，P < 0.01）。另外，术前平均ESR和CRP（分别为74.7毫米/小时和69.3毫克/升）降至平均值（t = 39.7，P < 0.001；t = 50.2，P < 0.001），而JOA评分（13.9分）显著升至23.0分（t = - 11.6，P < 0.01）。术前的后凸Cobb角（20.5°）术后降至4.8°（t = 14.0，P < 0.01）；然而，随访时后凸矫正情况保持稳定（t = - 0.476，P = 0.635）。此外，椎间融合时间平均为8.8个月（范围6 - 16个月）。
单纯后路病灶清除、椎间融合及内固定术可能是治疗CMLSTB患者的手术选择之一。
