Department of Spinal Surgery, The First Affiliated Hospital of Fujian Medical University, Chazhong Road 20th, Fuzhou, 350005, Fujian, China.
BMC Surg. 2021 Feb 12;21(1):84. doi: 10.1186/s12893-021-01092-8.
To explore the clinical safety and efficacy of single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion combined for the treatment of thoracolumbar spinal tuberculosis complicated with psoas abscesses.
A total of 38 patients diagnosed with thoracolumbar spinal tuberculosis complicated with psoas abscesses underwent surgery via single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion from January 2010 to September 2016 were enrolled in the study. The clinical efficacy of the approach was assessed based on parameters including operating time, blood loss, Cobb angle, visual analogue scale (VAS) scores, Frankel grade, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
The surgery duration was 224.4 ± 71.1 min with a blood loss of 731.8 ± 585.8 ml. The Cobb angle was corrected from 16.0 ± 15.4° preoperatively to 8.1 ± 7.4° postoperatively (P < 0.001, t = - 4.38), and returned to a level of 11.0 ± 8.5° at the final follow-up (P = 0.002, t = 3.38). Back pain was relieved, with the mean preoperative VAS of 3.5 ± 1.1 decreased to 0.7 ± 0.8 postoperatively (P < 0.001, t = 23.21) and then to 0.6 ± 0.5 at the final follow-up (P < 0.001, t = 17.07). Neurological function was improved in various degrees and psoas abscesses disappeared in all patients. The ESR and CRP decreased gradually after surgery and returned to normal at the final follow-up in all patients. All patients achieved bone fusion thoroughly and no recurrence of TB or surgical related complications was found at the final follow-up.
Single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion is a safe and effective approach for the management of thoracolumbar spinal tuberculosis complicated with psoas abscesses.
探讨后路一期清创、减压、钛网植骨融合联合治疗胸腰椎结核合并腰大肌脓肿的临床安全性和疗效。
2010 年 1 月至 2016 年 9 月，对 38 例胸腰椎结核合并腰大肌脓肿患者行后路一期清创、减压、钛网植骨融合术，观察手术时间、出血量、Cobb 角、视觉模拟评分（VAS）、Frankel 分级、红细胞沉降率（ESR）、C 反应蛋白（CRP）等指标，评价其临床疗效。
手术时间为 224.4±71.1 min，出血量为 731.8±585.8 ml。Cobb 角由术前的 16.0±15.4°矫正至术后的 8.1±7.4°（P<0.001，t=-4.38），末次随访时恢复至 11.0±8.5°（P=0.002，t=3.38）。术后腰痛缓解，术前 VAS 平均 3.5±1.1 分降至 0.7±0.8 分（P<0.001，t=23.21），末次随访时降至 0.6±0.5 分（P<0.001，t=17.07）。神经功能均有不同程度的改善，所有患者腰大肌脓肿消失。术后 ESR 和 CRP 逐渐下降，末次随访时均恢复正常。所有患者均获得彻底的骨融合，无结核复发或手术相关并发症。
后路一期清创、减压、钛网植骨融合治疗胸腰椎结核合并腰大肌脓肿安全有效。
