中国防痨杂志2024，Vol.46Issue(6)：707-712,6.DOI:10.19982/j.issn.1000-6621.20240034
一期后路病灶清除、颗粒植骨及内固定治疗胸腰椎结核的效果分析
Clinical effect of one-stage posterior debridement,autogenous morselized bone graft and internal fixation in the treatment of thoracolumbar tuberculosis
摘要
Abstract
Objective:To assess the clinical outcomes of single-stage posterior debridement,intervertebral autogenous morselized bone grafting,and internal fixation for the treatment of thoracolumbar tuberculosis.Methods:This retrospective analysis encompassed 31 patients with thoracolumbar tuberculosis treated at the Orthopedic Department of Xi'an Chest Hospital from January 2020 to June 2022,all undergoing single-stage posterior lesion clearance,intervertebral autogenous morselized bone grafting,and internal fixation.Surgical metrics analyzed included duration,blood loss,complications,and postoperative improvements in Visual Analogue Scale(VAS)scores,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),spinal cord function(Frankel classification),spinal curvature(Cobb angle),and bone graft fusion.Results:The study followed up 31 patients for a period ranging from 18 to 36 months,averaging(24.0±8.5)months.There were no instances of nerve or spinal cord injuries during surgeries,nor were there cases of postoperative wound infections.Surgical metrics revealed an average duration of(190.6±64.4)minutes and blood loss of(442.5±114.6)ml.Notably,at 3 months postoperatively,significant improvements were observed with the VAS scores decreasing from 5.5±1.9 to 2.2±0.7,ESR from(49.3±18.1)mm/1 h to(11.9±6.6)mm/1 h,and CRP levels from(34.1±16.7)mg/L to(7.9±5.5)mg/L,all demonstrating statistically significant reductions(t-values of 10.554,11.683,and 9.826,respectively;P＜0.001).Fusion was achieved after interbody bone grafting surgery.At the last follow-up,the Cobb angle was(9.6±3.3)°,and compared with preoperative((18.5±5.8)°),the difference was statistically significant(t=11.527,P＜0.001).The last follow-up Frankel neurological function grading was D grade in 2 cases and E in 29 cases.Conclusion:Single-stage posterior lesion clearance combined with intervertebral autogenous morselized bone grafting and internal fixation proves to be a safe and efficacious strategy for thoracolumbar tuberculosis patients fitting surgical criteria.The procedure demonstrates definitive therapeutic outcomes.关键词
结核,脊柱/颗粒物/治疗,临床研究性Key words
Tuberculosis,spinal/Particulate matter/Therapies,investigational分类
医药卫生引用本文复制引用
鲁增辉,张会军,岳晓通,闫锦玉..一期后路病灶清除、颗粒植骨及内固定治疗胸腰椎结核的效果分析[J].中国防痨杂志,2024,46(6):707-712,6.基金项目
西安市卫生健康委员会(2020yb39)Xi'an Health Commission(2020yb39) （2020yb39）
