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单纯后路与一期前后路手术治疗胸腰椎结核 被引量:15

Posterior surgery alone and one-stage combined anterior-posterior surgery for the treatment of thoracic and lumbar tuberculosis
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摘要 目的探讨单纯后路手术与一期前后路手术治疗胸腰椎结核是否有同等疗效。方法收集了2003年5月至2008年10月我院骨科采用椎弓根螺钉固定联合病灶清除植骨融合治疗的胸腰椎结核患者58例资料,其中单纯后路手术组30例,一期前后路手术组28例,均采用标准疗程三联或四联抗结核方案。比较两组患者围手术期指标,随访临床疗效、实验室及影像学资料,随访时间为43~108个月。结果两组患者在住院时间、手术时间、出血量、输血量、引流天数及引流量等方面的差异有明显统计学意义。所有患者的临床症状均得到有效改善。单纯后路组1例术后3年出现肋骨结核及窦道,1例术后4年出现其他部位结核,手术部位均未见复发。后凸Cobb角矫正均较满意。结论两种术式治疗短节段胸腰椎结核疗效相当,单纯后路手术创伤较小,疗效满意,适用于不能耐受前路手术及双侧腰大肌脓肿的患者。 Objective To investigate whether the posterior surgery and one-stage combined anterior- posterior surgery for the treatment of thoracic and lumbar tuberculosis had the same effect. Methods From May 2003 to October 2008, fifty-eight patients of thoracic and lumbar tuberculosis were treated by posterior pedicle screw fixation combined debridement, bone graft and fusion. Thirty of them were treated with posterior surgical procedure alone (group 1 ). Twenty-eight patients were treated with one-stage combined anterior-posterior surgery (group 2). All patients were managed by standard courses of chemotherapy with triple or quadruple anti-TB drugs. The perioperative indicators were compared. The clinical effects, laboratory and image data were followed up for 43 - 108 months. Results There were statistically significant differences in length of hospital stay, operative time, bleeding, blood transfusions, drainage time and drainage amount in two groups. The clinical symptoms had obvious relief in all cases. In group 1 ,one patient had rib tuberculosis and a fistula formation in the 3rd year,one patient had pulmonary and knee tuberculosis in the 4th year, but spinal tuberculosis and psoas abscess did not recurred. The kyphosis was corrected obviously and the loss of correction was not significant. Conclusions The two surgeries have good clinical effects in the short segment thoracic and lumbar tuberculosis. The posterior surgery alone has less operative trauma. It is proper for the patients who have bilateral psoas abscess or can't tolerate the anterior surgery.
出处 《复旦学报(医学版)》 CAS CSCD 北大核心 2013年第1期38-43,共6页 Fudan University Journal of Medical Sciences
基金 上海市医学领军人才项目(LJ10017) 上海市科委"科技创新行动计划"重点项目(08411952500)~~
关键词 胸腰椎结核 腰大肌脓肿 病灶清除 后路内固定 thoracic and lumbar tuberculosis psoas abscess debridement posterior instrumentation
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参考文献15

  • 1Talu U,Gogus A, Ozturk C, et al. The role of posteriorinstrumentation and fusion after anterior radicaldebridement and fusion in the surgical treatment ofspinal tuberculosis : Experience of 127 cases [J]. J SpinalDisord Tech ,2006 ,19 ?8) :554 - 559.
  • 2Oguz E, Sehirlioglu A,Altinmakas M,et al, A newclassification and guide for surgical treatment of spinaltuberculosis [J]. Int Orthop ,2008,32( 1) : 127 — 133.
  • 3Passias PG,Ma Y? Chiu YL, et al. Comparative safety ofsimultaneous and sataged anterior and posterior spinalsurgery [J], Spine’ 2012 ,37(3) :247 — 255.
  • 4陈农,李熙雷,董健,周晓岗,林红,阎作勤,姜晓幸,张键,郭常安,方涛林,马易群.一期后路全脊椎切除治疗胸腰椎恶性肿瘤[J].中国脊柱脊髓杂志,2010,20(8):624-628. 被引量:16
  • 5Lee SH, Sung JK, Park YM. Single-stage transpediculardecompression and posterior instrumentation in treatmentof thoracic and thoracolumbar spinal tuberculosis - Aretrospective case series [J]. J Spinal Disord Tech ,2006?19 (8) :595 - 602.
  • 6Hirakawa A,Miyamoto K,Masuda Tyet al. Surgical outcomeof 2-stage ( posterior and anterior) surgical treatment usingspinal instrumentation for tuberculous spondylitis [J].J Spinal Disord Tech ,2010,23(2) : 133 - 138.
  • 7李娟,周健,董健,李熙雷,周晓岗.单纯后路病灶清除植骨内固定治疗胸腰椎结核[J].中国骨与关节外科,2009,2(6):453-458. 被引量:12
  • 8Wang ZL,Ge ZH, Jin WD,et al. Treatment of spinaltuberculosis with ultrashort-course chemotherapy inconjunction with partial excision of pathologic vertebrae[J], Spine J ,2007,7(6) :671 -681.
  • 9戈朝晖,王自立,魏敏吉,張明,葛建忠.RP-HPLC法测定脊柱结核病椎组织中异烟肼的浓度[J].脊柱外科杂志,2008,6(3):165-168. 被引量:5
  • 10Jain AK. Tuberculosis of the spine: a fresh look at an olddisease [J]. J Bone Joint Surg ( Br) , 2010,92 ( 7) : 905-913.

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