摘要
目的：探讨一期前后联合入路治疗腰椎布鲁氏杆菌性脊柱炎的可行性及临床效果。方法选择2010年9月～2014年2月新乡医学院第一附属医院收治的腰椎布鲁氏杆菌性脊柱炎并采用一期前后联合入路治疗11例，均采用后路椎弓根螺钉固定、前路病灶清除椎间植骨融合。术后使用药物治疗6～8周以上，卧床休息1～3个月。对术前，术后1周，术后1、3个月患者的Cobb角、血沉及椎体疼痛视觉模拟评分（VAS）进行比较。结果所有患者术后切口均甲级愈合，无窦道及瘘管形成，无神经损伤症状加重。随访6～12个月，植骨块无移位，术后4～6个月植骨骨性融合，椎体高度无明显丢失，无后突畸形加重，无内固定松动、断裂。5例有神经症状者基本恢复，病灶均愈合。术前，术后1周及术后1、3个月的VAS评分分别为（7.00±1.00）、（1.45±0.52）、（0.27±0.05）、（0.45±0.19）分，血沉分别为（61.73±19.92）、（22.64±6.28）、（8.45±2.16）、（8.36±1.21）mm/h，术后较术前明显改善，差异有统计学意义（P〈0.05）。结论一期前后联合入路治疗腰椎布鲁氏杆菌性脊柱炎是一种可行的、安全的、有效的方法，能彻底清除病灶和充分脊髓神经减压，快速减轻患者疼痛，促进病情恢复，有效地矫正脊柱后凸畸形及预防脊柱后凸畸形的进展。
Objective To investigate the safety and clinical effect of one stage combined anterior and posterior approach in the treatment of lumbar Brucella spondylitis. Methods From September 2010 to February 2014, in the First Affiliated Hospital of Xinxiang Medical College, 11 patients with Brucella spondylitis and treated with one stage combined anterior and posterior approach were selected, all pateints were given posterior pedicle screw fixation, anterior debridement, intervertebral bone graft. And postoperative, all patients were treated with drug lasted 6 to 8 weeks or more and rest in bed for 1 to 3 months. Cobb angle, ESR and vertebral fracture VAS score before the operation, after the operatione 1 week, 1 month and 3 months were compared. Results After the operation, operation incisions were healed up primarily, no new sinus tractor and fistula, no worse nerve injury symptoms. Follow-up for 6 to 12 months, no dislocated plant bone mass, plant bones were bony fusion after operation 4 to 6 months, no significant vertebral height loss, no deformity aggravation, no internal fixation loosening or fracture. 5 cases had neurological symptoms recovery, the lesion were healed. Before the operation, after the operatione 1 week, 1 month and 3 months, VAS were （7.00±1.00）, （1.45±0.52）, （0.27±0.05）, （0.45±0.19） scores, ESR were （61.73±19.92）, （22.64±6.28）, （8.45±2.16）, （8.36±1.21） mm/h, these after the operotion were better than those before the operation, the differences were statistically significant （P〈 0.05）. Conclusion One stage combined anterior and posterior approach is a feasible, safe and effective method in the treatment of lumbar Brucella spondylitis, it can thoroughly clear focus of spinal, decompress sufficiently spinal cord, relieve paln quickly, promote recovery of illness, correct effectively the kyphosis deformity and prevent increasing of the angle of kyphotic deformity.
出处
《中国医药导报》
CAS
2015年第12期97-101,共5页
China Medical Herald
