Department of Orthopedic surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Int J Med Sci. 2020 Oct 16;17(17):2844-2849. doi: 10.7150/ijms.47309. eCollection 2020.
A retrospective study investigated and compared the results of lamina with spinous process (LSP), transverse process strut (TPS) and iliac graft (IG) as bone graft in thoracic single-segment spinal tuberculosis(TB) with the one-stage posterior approach of debridement, fusion and internal instrumentation. 99 patients treated from January 2012 to December 2015 were reviewed. LSP was performed in 35 patients (group A), TPS was undertaken in 33 patients (group B), and IG was carried out in 31 patients (group C). Surgical time, blood loss, hospitalization time, drainage volume, and follow-up (FU) duration were recorded. The visual analog scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), American Spinal Injury Association (ASIA) grade, segmental angle, intervertebral height and bone fusion time were compared between preoperative and final FU. All the patients were followed up for a mean 43.90±10.39 months in group A, 45.30±6.20 months in group B, 44.32±7.17 months in group C without difference(>0.05). The mean age was younger, the blood loss was less, the hospitalization time and the surgical time were shorter in group A than those in group B and C (<0.05). The drainage volume was less in group A than that in group B and group C. The CRP, ESR, VAS, and ODI were significantly decreased and there were no significant difference among the groups at the final FU. The neurological function after surgery was improved compared with preoperation among the groups. The bony fusion at a mean time 12.90±3.91 months in group A was longer than that in group B (6.75±1.55 months) and group C (5.52±1.64 months) (<0.05). No significant difference was found at the mean segmental angle, mean intervetebral height of preoperation and final FU among the groups (>0.05). In conclusion, the LSP and TPS as bone graft are reliable, safe, and effective for single-segment stability reconstruction for surgical management of thoracic TB and TPS could be new bone graft methods.
一项回顾性研究调查并比较了经后路一期清创、融合及内固定术治疗胸段单节段脊柱结核时，使用椎板棘突（LSP）、横突支柱（TPS）和髂骨植骨（IG）作为植骨的结果。回顾了 2012 年 1 月至 2015 年 12 月收治的 99 例患者。其中 35 例行 LSP（A 组），33 例行 TPS（B 组），31 例行 IG（C 组）。记录手术时间、出血量、住院时间、引流量和随访（FU）时间。比较术前与最终 FU 时的视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）、红细胞沉降率（ESR）、C 反应蛋白（CRP）、美国脊柱损伤协会（ASIA）分级、节段角、椎间高度和骨融合时间。A 组、B 组和 C 组的所有患者平均随访时间分别为 43.90±10.39 个月、45.30±6.20 个月和 44.32±7.17 个月，差异无统计学意义（>0.05）。A 组患者的平均年龄较小，出血量较少，住院时间和手术时间均短于 B 组和 C 组（<0.05）。A 组的引流量少于 B 组和 C 组。C 组 CRP、ESR、VAS 和 ODI 在最终 FU 时均显著降低，且组间差异无统计学意义。与术前相比，术后各组的神经功能均得到改善。A 组的平均骨融合时间为 12.90±3.91 个月，长于 B 组（6.75±1.55 个月）和 C 组（5.52±1.64 个月）（<0.05）。组间术前和最终 FU 时的平均节段角和平均椎间高度差异无统计学意义（>0.05）。结论：LSP 和 TPS 作为植骨材料用于胸段单节段脊柱结核的后路一期清创、融合及内固定术的单节段稳定性重建是可靠、安全且有效的，TPS 可作为新的植骨方法。
Zotero 插件
