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基于脊柱不稳肿瘤评分选择骨移植类型治疗胸腰椎脊柱结核的回顾性单中心队列研究。

Selection of bone graft type for the surgical treatment of thoracolumbar spinal tuberculosis based on the spinal instability neoplastic score: a retrospective single-center cohort study.

机构信息

Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.

Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2023 Jun 24;24(1):520. doi: 10.1186/s12891-023-06620-6.

Abstract

OBJECTIVES

This study aimed to establish a standard for selecting bone graft type for thoracolumbar spinal tuberculosis surgery based on the spinal instability neoplastic score (SINS).

METHODS

Patients with thoracolumbar tuberculosis who underwent one-stage debridement posteriorly and instrumentation were divided into a structural bone graft group (SBG) (51 cases) and a non-structural bone graft group (NSBG) (54 cases) according to their SINS. SBG was performed when the SINS was ≥ 13 and NSBG was performed when it was 7 ≤ SINS ≤ 12. Baseline data, clinical outcomes, and imaging outcomes were collected and statistically analyzed between the two groups.

RESULTS

Significant improvements in clinical and imaging outcomes were achieved in both groups. Compared to the SBG group, the operation time of the NSBG group was shorter, the intraoperative blood loss of the NSBG group was less, the bone fusion time of the NSBG group was faster.

CONCLUSION

Non-structural and structural bone grafting can achieve comparable therapeutic effects in patients with spinal tuberculosis, and a suitable selection of bone grafts based on quantitative SINS will make full use of the advantages of different bone grafts.

摘要

目的

本研究旨在根据脊柱不稳定肿瘤评分(SINS)建立一种用于胸腰椎脊柱结核手术的植骨类型选择标准。

方法

根据 SINS 将接受一期后路清创和内固定的胸腰椎结核患者分为结构性植骨组(SBG)(51 例)和非结构性植骨组(NSBG)(54 例)。SINS≥13 时行 SBG,7≤SINS≤12 时行 NSBG。收集两组患者的基线资料、临床疗效和影像学结果,并进行统计学分析。

结果

两组患者的临床和影像学结果均有显著改善。与 SBG 组相比,NSBG 组的手术时间更短,术中出血量更少,骨融合时间更快。

结论

结构性植骨和非结构性植骨均可在脊柱结核患者中取得相似的疗效,根据定量 SINS 选择合适的植骨方式可以充分发挥不同植骨方式的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6508/10290412/ad4da11be312/12891_2023_6620_Fig1_HTML.jpg

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