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结核性截瘫一期前后路联合手术的疗效

Outcome of Single Stage Anterior and Posterior Surgery for Tuberculous Paraplegia.

作者信息

Yadav Krishan, Mohan Patel Jeegar, Daga Rahul Ghanshyamdas, Sadaria Mohan

机构信息

Assistant Professor, Madhubani Medical College, Madhubani, Bihar, India.

Assistant Professor, RKDF Medical College, Bhopal, 83, Sainagar Society, Behind Bhulka Bhavan School, Adajan, Surat, Gujarat, India.

出版信息

J Pharm Bioallied Sci. 2023 Jul;15(Suppl 2):S1152-S1155. doi: 10.4103/jpbs.jpbs_184_23. Epub 2023 Apr 28.

Abstract

BACKGROUND

Morbidity and mortality from tuberculosis, a significant infectious illness, are expected to rise worldwide. The projected number of new cases rose from 7.5 million in 1990 to 11.9 million in 2005, a 58.6% increase in 2011. The widespread belief that TB is no longer a public health concern is unfounded; on the contrary, the link between HIV/AIDS and antibiotic resistance has further exacerbated the crisis that already existed. Similar to the nations in sub-Saharan Africa, India is now considered a Group IV country, with an annual risk of infection between 1% and 2.5%. 2. Although 60% of TB cases occur in people who are HIV-positive, only 3-5% of cases in HIV-negative individuals are skeletal. The most frequent type of articuloskeletal tuberculosis is spinal tuberculosis.

AIM

  1. The goal of this study is to evaluate the neurological outcome of anterior debridement, fusion, posterior instrumentation, and early rehabilitation in individuals with spinal cord injuries. 2. The goal of this study is to determine the prevalence of pressure ulcers, hypostatic pneumonia, and urinary tract infections urinary tract infections (UTIs) among these individuals. 3. The goal of this study is to determine the frequency of graft-related problems. 4. See how well these individuals are able to keep their corrected deformities from returning.

MATERIALS AND METHODS

Patients who had simultaneous anterior (anterior debridement and bone grafting) and posterior (posterior instrumentation and fusion) procedures were followed prospectively.

RESULT

Thirty patients' films were examined. In addition, cord edema was suggested in 13 of the patients based on the presence of strong signal intensities there. Myelomalacia signs were seen in one patient, but he or she went on to make a complete neurological recovery. The average duration of operation was 355 minutes, and this included the time needed to position the patient for the two separate procedures.

CONCLUSION

There was an 89.5% rate of neurological recovery with an average corrected loss of 6.98 degrees (0.20 degrees to 35.90 degrees), and the complication rate was acceptable in the group analyzed.

摘要

背景

结核病作为一种严重的传染病,预计全球范围内其发病率和死亡率将会上升。预计新发病例数从1990年的750万增加到2005年的1190万,在2011年增长了58.6%。认为结核病不再是公共卫生问题的普遍看法是没有根据的;相反,艾滋病毒/艾滋病与抗生素耐药性之间的关联进一步加剧了业已存在的危机。与撒哈拉以南非洲国家类似,印度现在被视为第四类国家,年感染风险在1%至2.5%之间。2. 虽然60%的结核病病例发生在艾滋病毒呈阳性的人群中,但艾滋病毒阴性个体中只有3%至5%的病例是骨骼结核。骨关节结核最常见的类型是脊柱结核。

目的

  1. 本研究的目的是评估脊髓损伤患者前路清创、融合、后路内固定和早期康复后的神经功能结果。2. 本研究的目的是确定这些患者中压疮、坠积性肺炎和尿路感染(UTIs)的患病率。3. 本研究的目的是确定移植相关问题的发生率。4. 观察这些患者保持矫正畸形不复发的情况如何。

材料与方法

对同时进行前路(前路清创和植骨)和后路(后路内固定和融合)手术的患者进行前瞻性随访。

结果

检查了30例患者的影像学片子。此外,根据其中13例患者存在强信号强度提示有脊髓水肿。1例患者出现脊髓软化征象,但该患者随后实现了完全神经功能恢复。平均手术时长为355分钟,这包括为两个单独手术给患者摆放体位所需的时间。

结论

神经功能恢复率为89.5%,平均矫正丢失6.98度(0.20度至35.90度),在所分析的组中并发症发生率是可接受的。

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