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在一家三级护理中心,接受胸腰椎结核后路器械稳定与经椎弓根减压治疗的患者的临床转归:一项描述性横断面研究。

Clinical Outcome of Posterior Instrumented Stabilization and Transpedicular Decompression in Patients Presenting with Thoracic or Lumbar Spinal Tuberculosis in a Tertiary Care Center: A Descriptive Cross-sectional Study.

机构信息

Department of Orthopedics and Trauma Surgery, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.

Department of Orthopedics, National Trauma Center, Mahaboudha, Kathmandu, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2024 Jul 31;62(276):521-525. doi: 10.31729/jnma.8718.

Abstract

INTRODUCTION

Posterior instrumented stabilization is a commonly done surgery in spinal tuberculosis. This study aims to evaluate the clinical, radiological, and neurological outcomes of posterior instrumented stabilization and transpedicular decompression in thoracic and lumbar spinal tuberculosis.

METHODS

A descriptive cross-sectional study was conducted for one and a half years with at least six months of follow-up in a tertiary care center. The study was approved by the Institutional Review Committee (Reference number: 119 (6-11-5) 2/075-076). Total sampling was done and the study included patients over 18 years of age with spinal tuberculosis of the thoracic or lumbar regions. These patients underwent posterior instrumented stabilization and transpedicular decompression at the tertiary care center. The age, site of involvement, Visual Analog Scale score for back pain, neurological status as per Frankel Neurology grading, and local kyphotic angle in X-ray were recorded. The median, interquartile range and percentage were calculated. The data was entered in Microsoft Excel 2016 and analysis was done using Epi Info software version 7.2.

RESULTS

Thoracic level was most commonly involved in 14 (46.68%) cases. The median back pain as assessed by the Visual Analogue Scale score improved from 8 to 2 at the 6-month follow-up. There was improvement in the neurological grading of all cases and there was no loss of correction in the local kyphotic angle till the final follow-up. The median age of cases was 48 years (interquartile range: 28-62.50).

CONCLUSIONS

Posterior instrumented stabilization and transpedicular decompression in adult patients with thoracic or lumbar spinal tuberculosis achieves improvements in clinical, radiological, and neurological outcomes.

摘要

引言

后路器械稳定是脊柱结核中常用的手术方法。本研究旨在评估后路器械稳定和经椎弓根减压术治疗胸腰椎脊柱结核的临床、放射学和神经学结局。

方法

在一家三级保健中心进行了为期一年半的描述性横断面研究,随访时间至少为 6 个月。该研究得到了机构审查委员会的批准(参考编号:119(6-11-5)2/075-076)。采用总体抽样,研究对象为年龄在 18 岁以上的胸腰椎脊柱结核患者。这些患者在三级保健中心接受后路器械稳定和经椎弓根减压术治疗。记录患者的年龄、受累部位、背痛视觉模拟评分(VAS)、根据 Frankel 神经学分级的神经状态以及 X 线局部后凸角。计算中位数、四分位距和百分比。将数据输入 Microsoft Excel 2016 并使用 Epi Info 软件版本 7.2 进行分析。

结果

14 例(46.68%)最常见的受累部位为胸椎。VAS 评估的腰痛中位数从 6 个月随访时的 8 分改善至 2 分。所有病例的神经分级均有改善,局部后凸角的矫正丢失直至最终随访。病例的中位年龄为 48 岁(四分位距:28-62.50)。

结论

后路器械稳定和经椎弓根减压术治疗成人胸腰椎脊柱结核可改善临床、放射学和神经学结局。

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本文引用的文献

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Spinal Tuberculosis: Current Concepts.脊柱结核:当前概念
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