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经皮脊柱内镜清创及灌洗在骶髂关节结核中的临床应用

[Clinical application of percutaneous spinal endoscopy debridement and lavage in sacroiliac joint tuberculosis].

作者信息

Guan Xiao-Li, Xue Wen, Wang Dong, Ma Ya-Qiong, Zhang Qun-Li, Liu Lin, Ma Zhi-Yu, Ma Jian

机构信息

The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China.

出版信息

Zhongguo Gu Shang. 2021 Jul 25;34(11):1006-10. doi: 10.12200/j.issn.1003-0034.2021.11.004.

Abstract

OBJECTIVE

To investigate the feasibility and clinical efficacy of percutaneous spinal endoscopic debridement and lavage for the treatment of sacroiliac joint tuberculosis.

METHODS

The clinical data of 7 patients with sacroiliac joint tuberculosis treated with percutaneous spinal endoscopic debridement and lavage from January 2007 to April 2009 were retrospectively analyzed. There were 2 males and 5 females, aged from 29 to 69 years old, 4 cases on the right side of the lesion and 3 cases on the left side. The course ranged from 8 to 144 months. According to Kim classification, 5 cases were type Ⅲ and 2 cases were type Ⅳ. All patients were treated with HRZE quadruple anti tuberculosis drugs for 2 to 6 weeks beforeoperation. VAS, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Oswestry Disability Index (ODI) were compared before and after surgery.

RESULTS

All the operations were successful, the intraoperative blood loss was less than 50 ml on average, and no complications such as hematoma and infection were occurred. The follow-up time of 7 cases ranged from 18 to 40 months. Pain relief was obvious, and there was a statistical result in the VAS, ESR, and ODI of the patients at 1, 3, 6, 12, 18 months after operation compared with before treatment. At the final follow-up, the patient's clinical, imaging and laboratory examinations showed that the infection had disappeared, and the patient returned to normal life and work.

CONCLUSION

Percutaneous spine endoscopic debridement and lavage has less tissue trauma, targeted operation, definite curative effects, and quick postoperative recovery, which has explored new options for minimally invasive treatment of sacroiliac joint tuberculosis.

摘要

目的

探讨经皮脊柱内镜清创及灌洗治疗骶髂关节结核的可行性及临床疗效。

方法

回顾性分析2007年1月至2009年4月采用经皮脊柱内镜清创及灌洗治疗的7例骶髂关节结核患者的临床资料。其中男性2例,女性5例,年龄29~69岁,病变位于右侧4例,左侧3例。病程8~144个月。按Kim分类,Ⅲ型5例,Ⅳ型2例。所有患者术前均采用HRZE四联抗结核药物治疗2~6周。比较手术前后的视觉模拟评分(VAS)、红细胞沉降率(ESR)、C反应蛋白(CRP)及Oswestry功能障碍指数(ODI)。

结果

所有手术均成功,术中平均出血量少于50 ml,未发生血肿、感染等并发症。7例患者随访时间为18~40个月。疼痛缓解明显,术后1、3、6、12、18个月患者的VAS、ESR及ODI与治疗前比较差异有统计学意义。末次随访时,患者临床、影像学及实验室检查显示感染消失,患者恢复正常生活及工作。

结论

经皮脊柱内镜清创及灌洗组织创伤小、手术针对性强、疗效确切、术后恢复快,为骶髂关节结核的微创治疗探索了新的选择。

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