摘要
目的分析47例腰椎术后并发椎间盘炎患者的诊治经过并随访,探讨其临床特点,为临床诊断治疗提供决策依据。方法分析2001年1月-2011年1月收治的47例腰椎间盘术后椎间盘炎患者病情,其中保守治疗25例,保守治疗1周无效而改行手术治疗5例(分析时归入手术组),一期手术治疗17例;运用VAS疼痛评分系统和Oswestry功能障碍指数评分系统进行临床疗效评价。结果术后所有患者均获1年以上随访,影像学提示植骨融合良好,未出现椎间盘炎复发;保守组治疗后1个月、1年VAS评分分别为(2.88±0.73)、(1.40±1.04)分,ODI指数分别为(22.12±4.10)%、(7.48±1.87)%,与治疗前相比均有明显改善,差异有统计学意义(P<0.05);手术组治疗后1个月、1年VAS评分分别为(2.41±0.50)、(1.27±1.08)分,ODI指数分别为(14.27±3.76)%、(6.86±1.93)%,与治疗前相比均有明显改善,差异有统计学意义(P<0.05);组间比较,1个月时手术组VAS评分及ODI指数优于保守治疗组(P<0.05),1年时这两项指标间的差异则不明显,差异无统计学意义。结论腰椎术后并发椎间盘炎,应根据病情选择治疗方式,对于保守治疗≥1周无好转病例,应及时手术治疗;正确选择治疗方式,远期均可获得满意疗效。
OBJECTIVE To study the diagnosis and treatment of post-operative lumbar discitis by exploring the clinical characteristics so as to guide the clinical diagnosis and treatment.METHODS During Jan 2001 to Jan 2011,47 cases of patients with post-operative lumbar discitis were retrospectively studied and divided into two groups according to the therapeutic method,while 22 cases were given the surgical treatment and 25 cases were carried out for conservative treatment.The visual analogue scales system and Oswestry disability index were applied to judge the efficacy.RESULTS The follow-up was more than 1 year with no death and withdraw.The imaging materials displayed that the intervertebral space merged together and non discitis relapsed.The VAS score and ODI index of 1 month（2.88±0.73,1.40±1.04）and 1year（22.12±4.10,7.48±1.87）improved greatly in both of the two groups when compared with that before the treatment.Only the VAS score and ODI index of 1 month or 1 year（2.41±0.50,1.27±1.08）and（14.27±3.76,6.86±1.93）proved to be superior to the conservative group（P0.05）,while there was no significant difference between the two groups in such indexes when referring to 1 year.CONCLUSIONFor the cases complicated with lumbar discitis after the lumbar surgery,it is necessary to choose the treatment approach based on the condition,and timely surgical treatment is recommended for the cases whose conditions are not improved under the conservative treatment.The appropriate treatment approach can achieve long-term satisfactory therapeutic effect.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第14期3397-3399,共3页
Chinese Journal of Nosocomiology
关键词
椎间盘炎
手术治疗
保守治疗
Discitis
Surgical treatment
Conservative treatment
