马良 1唐伟 1地里下提·阿不力孜 1古甫丁 1盛杰1
作者信息
- 1. 830049 乌鲁木齐,新疆维吾尔自治区胸科医院骨科
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摘要
Abstract
Objective To compare and analyze the clinical efficacy of anterior,posterior and anterior and posterior combined surgical operation for the treatment of patients with thoracolumbar spinal tuberculosis.Methods We analyzed retrospectively the clinical data from 585 patients with thoracic and lumbar spinal tuberculosis in 1136 patients with spinal tuberculosis admitted in Chest hospital of the xinjiang uygur autonomous region during January 2010 to June 2016.All patients were divided into three groups including 155 cases with anterior debridement and bone graft,anterior internal fixation as A group,158 cases with posterior debridement and pedicle fixation as B group and 272 cases with anterior debridement and bone grafting,posterior pedicle fixation as C group according to the different surgical procedure.Some clinical indexes including operation time,intraoperative blood loss,changes of erythrocyte sedimentation rate before and after operation,hospitalization time,visual analogue scale (VAS) for pain,Frankel grading(spinal cord injury severity assessment criteria) improvement,bone graft fusion time and the incidence of complications were observed to assess efficacy for all patients during the follow-up for 3 to 36 months.Results All patients completed the operation successfully.The postoperative Cobb angle was compared among the 3 groups patients with lumbar spinal tuberculosis:(19.3±3.3)° in A group,(17.8±5.3)° in B group and (15.6±4.4)° in C group (F=0.894,P=0.422).The postoperative Cobb angle was compared among the 3 groups patients with thoracic spinal tuberculosis:(18.4±2.3)° in A group,(19.5±2.6)° in B group and (16.4±2.8)° in C group (F=2.916,P=0.080).The VAS was compared among the 3 groups patients with thoracic spinal tuberculosis:(3.9±1.3) in A group,(3.8±1.2) in B group and (3.7±1.2) in C group (F=0.471,P=0.625).The bone graft fusion time was compared among the 3 groups patients with thoracic spinal tuberculosis:(9.3±2.9) days in A group,(9.7±3.2) days in B group and (9.3±3.1) days in C group (F=0.471,P=0.625).The differences of all above indexes were compared before and after operation without significant statistically.There were Frankel grading B in 4 cases,C in 19 cases and D in 110 cases before operation and C in 2 cases,D in 17 cases and E in 117 cases after operation in three groups.Conclsion Under the premise of standardized antituberculous drugs treatment,three kinds of surgical procedure for treatment of patients with thoracolumbar spinal tuberculosis can achieve good outcome.关键词
结核,脊柱/外科手术,选择性/方案评价/治疗结果Key words
Tuberculosis, spinal/Surgical procedures, elective/Program evaluation/Treatment outcome
