First Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China.
Department of Orthopedic, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China.
Medicine (Baltimore). 2024 Oct 25;103(43):e40232. doi: 10.1097/MD.0000000000040232.
This study aims to explore the clinical efficacy and feasibility of preoperative 1-week chemotherapy for patients with spinal tuberculosis (STB) undergoing complete lesion removal. Clinical data of 76 patients with STB who underwent complete focal debridement in our hospital were collected from June 2020 to September 2023. The patients were divided into 38 cases of preoperative 1-week chemotherapy group (Group A) according to the length of preoperative chemotherapy, and 38 cases of preoperative 2 to 4-week chemotherapy group (Group B). Perioperative related, imaging, and laboratory examination indices as well as postoperative neurological function recovery, postoperative pain recovery, related complications, and clinical efficacy were analyzed to compare the clinical efficacy of the 2 groups. All patients successfully completed the treatment of stage I complete lesion removal combined with bone grafting fusion and internal fixation. The difference in erythrocyte setting rate and C-reactive protein at the same postoperative observation time between the 2 groups was not statistically significant (P > .05). The visual analogue scale scores of patients in the 2 groups decreased significantly with prolonged time, and the difference was statistically significant (P < .05). All patients achieved satisfactory clinical efficacy (P < .05). All patients achieved good clinical outcomes, the difference between the groups was not statistically significant (P > .05). The difference in incision healing rate at 3 months postoperatively and bone graft fusion rate at 6 months postoperatively was not statistically significant between the 2 groups (P > .05). The dissemination and recurrence of Mycobacterium tuberculosis were not statistically significantly different between the 2 groups after surgery (P > .05). In summary, with complete lesion clearance, 1 week of preoperative chemotherapy is feasible in patients with STB with varying degrees of neurological dysfunction.
本研究旨在探讨术前 1 周化疗治疗脊柱结核（STB）患者完全病灶清除的临床疗效和可行性。收集 2020 年 6 月至 2023 年 9 月我院收治的 76 例 STB 患者完全病灶清除术的临床资料，根据术前化疗时间长短将患者分为术前 1 周化疗组（A 组）38 例和术前 2~4 周化疗组（B 组）38 例。分析围手术期相关、影像学和实验室检查指标及术后神经功能恢复、术后疼痛恢复、相关并发症及临床疗效，比较两组的临床疗效。所有患者均顺利完成一期完全病灶清除联合植骨融合内固定术治疗。两组患者同一术后观察时间红细胞沉降率和 C 反应蛋白比较，差异无统计学意义（P＞0.05）。两组患者术后视觉模拟评分均随时间延长明显下降，差异有统计学意义（P＜0.05）。所有患者均获得满意的临床疗效（P＜0.05）。所有患者均获得满意的临床疗效（P＜0.05）。所有患者均获得满意的临床疗效（P＜0.05）。两组患者术后 3 个月切口愈合率和术后 6 个月植骨融合率比较，差异无统计学意义（P＞0.05）。两组患者术后结核菌传播和复发情况比较，差异无统计学意义（P＞0.05）。总之，对于神经功能障碍程度不同的 STB 患者，在完全病灶清除的前提下，术前 1 周化疗是可行的。
