| 胡斌,钱选昆,王文己.一期单纯后路和前后联合入路病灶清除植骨内固定术治疗脊柱结核的临床疗效对比[J].脊柱外科杂志,2016,14(5):267-271. |
一期单纯后路和前后联合入路病灶清除植骨内固定术治疗脊柱结核的临床疗效对比  点此下载全文 (Fulltext) |
| 胡斌 钱选昆 王文己 |
| 兰州大学第一医院骨科, 甘肃 730000 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2016.05.003 |
| 摘要点击次数: 1453 |
| 全文下载次数: 807 |
| 摘要： |
| 目的 对比一期单纯后路和前后联合入路病灶清除植骨内固定术治疗脊柱结核的临床疗效。方法 回顾性分析2011年1月-2015年1月本院收治的71例胸腰椎结核患者资料，行一期后路病灶清除植骨内固定术治疗37例（A组），行一期前路病灶清除植骨并后路内固定术治疗34例（B组）。2组患者术前均给予标准抗结核治疗2~3周，记录手术时间、术中出血量、住院天数、并发症发生率，以及手术前后红细胞沉降率（ESR）、C反应蛋白（CRP）、Cobb角和美国脊髓损伤协会（ASIA）分级。结果 所有手术顺利完成，术后随访8~22个月，平均随访14个月。2组在手术前后Cobb角、ESR、CRP、ASIA分级、Cobb角纠正度及术后并发症发生率方面的差异均无统计学意义（P>0.05）。A组在手术时间、术中出血量及住院天数方面均低于B组，差异有统计学意义（P<0.05）。末次随访时所有患者均获得骨性融合，未出现结核复发及内固定松动、断裂等并发症。结论 一期单纯后路病灶清除植骨内固定与前路病灶清除植骨并后路内固定治疗胸腰椎结核均可取得满意疗效，但单纯后路在手术时间、术中出血量及住院天数上均低于前后路联合入路，有明显优势。 |
| 关键词：胸椎 腰椎 结核 脊柱 清创术 内固定器 |
| Comparison between clinical effects of one-stage posterior approach alone and combination of anterior and posterior approach in treatment of spinal tuberculosis Fulltext |
| HU Bin QIAN Xuan-kun WANG Wen-ji |
| Department of Orthopaedics, First Hospital of Lanzhou University, Lanzhou 730000, Gansu, China |
| Fund Project: |
| Abstract: |
| Objective To investigate the clinical efficacy of one-stage posterior debridement,bone graftting and internal fixation in the treatment of thoracolumbar tuberculosis,and compared with combination of anterior and posterior approach. Metheds From January 2011 to January 2015,data of 71 patients with thoracolumbar tuberculosis were reviewed retrospectively. Thirtyseven patients underwent one-stage posterior debridement,bone grafting and internal fixation(group A),and 34 underwent anterior debridement,bone grafting and posterior internal fixation(group B). All patients were given standard anti-tuberculosis treatment for 2-3 weeks. The erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),Cobb's angle and American spinal injury association(ASIA) classification before and after surgery were recorded,as well as intraoperative blood loss, operative time,hospitalization days and complication rates. Results All operations were completed successfully. All the patients were followed for a mean period of 14 months(ranged 8-22 months). There were no significant difference in ESR, CRP,ASIA classification,Cobb's angle and complication rates between 2 groups(P>0.05). The differences in intraoperative blood loss,operative time,hospitalization days between 2 groups were statistically significant(P<0.05). Bone fusion was achieved in all patients at the final follow-up. No complications such as tuberculosis recurrence and internal fixation failure were observed. Conclusion Either one-stage posterior approach alone or combined anterior and posterior approach for treatment of thoracolumbar tuberculosis could achieve satisfactory therapeutic effect. However,the posterior approach alone has significant advantages in less operative time,intraoperative blood loss and hospitalization days. |
| Keywords:Thoracic vertebrae Lumbar vertebrae Tuberculosis spinal Debridement Internal fixators |
|
|
HTML
查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
|
|
