局解手术学杂志2017，Vol.26Issue(12)：868-872,5.DOI:10.11659/jjssx.05E017077
椎间孔入路穿刺引流联合椎旁肌间隙入路内固定治疗腰骶椎结核的临床研究
Intervertebral foramen puncture combined with internal fixation via paraspinal approach for treatment of lum-bosacral tuberculosis
摘要
Abstract
Objective To explore the operative indications and efficacy of intervertebral foramen puncture combined with internal fixa -tion via paraspinal approach in the treatment of lumbosacral tuberculosis .Methods A total of 69 patients who treated with intervertebral fo-ramen puncture combined with internal fixation via paraspinal approach in spinal surgery department of Daping hospital affiliated to army medical university from January 2010 to January 2017 were retrospectively analyzed .All patients had preoperative standardized oral isoniazid , rifampicin,pyrazinamide,ethambutol for 2 to 4 weeks.The surgical methods included intervertebral foramen puncture ,drainage of paraverte-bral abscess and posterior paraspinal muscle gap approach fixation .The surgery time,intraoperative blood loss ,postoperation drainage ,abscess absorption,healing of lesions and Oswestry scores were recorded and observed .Results The operation time was from 130 to 220 minutes, with average of 140 minutes;the blood loss was from 50 to 150 mL,with average of 110 mL;the total volume of drainage was 30 to 180 mL, with average of 70 mL.All patients were followed up for 12 to 21 months.All cases were recovered except 1 patient who suffered from sacral tuberculosis received debridement and suturing caused by cutaneous necrosis .There was no infection , injury of spinal cord and nerve nor looseness or shift of internal fixation .The abscess was completely absorbed after 12 months.The Oswestry scores before surgery was (68.15 ± 18.36),while it was(11.64 ±8.12) at final followed-up,the difference was significant(P<0.05).Conclusion The surgical treatment of intervertebral foramen puncture combined with internal fixation via paraspinal approach is effective for patients who suffered large paraverte -bral abscess, parts of vertebral body collapse with segmental instability and mild kyphosis of spine with spinal cord disfunction ,which is a safe and effective surgical method .关键词
脊柱结核/腰骶椎/椎间孔/椎椎旁肌/内固定Key words
spinal tuberculosis/lumbosacral vertebrae/intervertebral foramen/paraspinal muscle/internal fixation分类
医药卫生引用本文复制引用
王颖博,范伟力,朱军,胡波,殷翔,刘鹏,赵建华..椎间孔入路穿刺引流联合椎旁肌间隙入路内固定治疗腰骶椎结核的临床研究[J].局解手术学杂志,2017,26(12):868-872,5.基金项目
国家自然科学基金 (81501883) （81501883）
