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OLIF 联合后路内固定治疗单节段腰椎结核的疗效评价:单中心回顾性队列研究。

Evaluation of the efficacy of OLIF combined posterior internal fixation for single-segment lumbar tuberculosis: a single-center retrospective cohort study.

机构信息

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, No.1 YouYi Road, Yuan Jia Gang, Yu Zhong District, Chongqing, 400016, China.

出版信息

BMC Surg. 2022 Feb 13;22(1):54. doi: 10.1186/s12893-022-01492-4.

Abstract

OBJECTIVE

To evaluate the clinical efficacy of oblique lateral interbody fusion (OLIF) combined posterior fixation for single-segment lumbar tuberculosis (TB).

METHODS

The medical records of spinal TB patients who were admitted to our department from January 2016 to December 2018 were retrospectively reviewed, and those meeting the inclusion criteria were finally included for analysis. The operative time, operative blood loss, hospital stay, visual analogue scale (VAS) score, Oswestry disability index (ODI), Cobb angle of surgical segment, bone graft fusion rate, erythrocytic sedimentation rate (ESR), C-reactive protein (CRP), neurological function (ASIA grade) and complications of the included patients were all recorded and analyzed.

RESULTS

Thirty-nine patients with lumbar TB were finally included. The mean operative time, operative blood loss, and hospital stay were 135.8 ± 19.2 min, 239.4 ± 84.7 ml, and 9.5 ± 2.7 days, respectively. The mean follow-up time was 26.3 ± 7.5 months. During the follow-up, both VAS score and ODI were significantly improved at 1 month, 3 months, 6 months, 1 year postoperative, and the last follow-up, compared with preoperative (P < 0.001). Cobb angle was significantly corrected at 1 month postoperatively (P < 0.001), however, from 3 months postoperative to the last follow-up, Cobb angle was getting lost (P < 0.01). Bone graft fusion rate at 3 months, 6 months, 1 year postoperative, and last follow-up were 66.67%, 87.18%, 94.88%, and 100%, respectively. Compared with preoperative, ESR and CRP were both showed significant decrease at 1 and 6 months postoperative, and the last follow-up (P < 0.001). At the last follow-up, all patients had improvement in ASIA grade compared with preoperative (P < 0.001). Six patients were found with postoperative complications, and all were cured after active treatment.

CONCLUSIONS

OLIF combined posterior internal fixation is safe and effective in the treatment of single-segment lumbar TB, with satisfactory pain relief, improvement of lumbar and neurological function, and deformity correction.

摘要

目的

评估斜外侧椎间融合术(OLIF)联合后路固定治疗单节段腰椎结核(TB)的临床疗效。

方法

回顾性分析 2016 年 1 月至 2018 年 12 月我院收治的脊柱结核患者的病历资料,纳入符合标准的患者进行分析。记录并分析纳入患者的手术时间、术中出血量、住院时间、视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)、手术节段 Cobb 角、植骨融合率、红细胞沉降率(ESR)、C 反应蛋白(CRP)、神经功能(ASIA 分级)和并发症。

结果

最终纳入 39 例腰椎 TB 患者。平均手术时间、术中出血量和住院时间分别为 135.8±19.2min、239.4±84.7ml 和 9.5±2.7d。平均随访时间为 26.3±7.5 个月。随访期间,患者术后 1 个月、3 个月、6 个月、1 年及末次随访时 VAS 评分和 ODI 均较术前显著改善(P<0.001)。术后 1 个月 Cobb 角明显矫正(P<0.001),但从术后 3 个月至末次随访时 Cobb 角逐渐丢失(P<0.01)。术后 3 个月、6 个月、1 年及末次随访时植骨融合率分别为 66.67%、87.18%、94.88%和 100%。与术前相比,术后 1 个月和 6 个月时 ESR 和 CRP 均显著降低,末次随访时也显著降低(P<0.001)。末次随访时,与术前相比,所有患者的 ASIA 分级均有改善(P<0.001)。术后 6 例患者出现并发症,经积极治疗后均治愈。

结论

OLIF 联合后路内固定治疗单节段腰椎 TB 安全有效,可有效缓解疼痛,改善腰椎和神经功能,矫正畸形。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6529/8842924/74dda50f2bf4/12893_2022_1492_Fig1_HTML.jpg

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