摘要
目的探讨椎间孔镜技术辅助抗生素治疗腰椎间隙感染的疗效。方法回顾性分析我科2010年11月~2017年4月28例腰椎间隙感染,观察组采用经皮椎间孔镜技术辅助抗生素治疗腰椎间隙感染15例,对照组采用抗生素及卧床保守治疗13例腰椎间隙感染,比较2组治疗前和治疗后2周、1个月、3个月、末次随访疼痛视觉模拟评分(Visual Analogue Scale,VAS),日本骨科协会(Japanese Orthopaedic Association,JOA)评分及Oswestry功能障碍指数(Oswestry Disability Index,ODI),末次随访采用改良MacNab标准评价疗效。结果观察组患者疼痛消失时间(3.6±1.3)周,明显短于对照组(7.1±0.7)周(t=-8.645,P=0.000);红细胞沉降率正常时间(4.4±1.7)周,显著短于对照组(9.8±1.1)周(t=-10.134,P=0.000);观察组C-反应蛋白转阴时间(3.6±1.3)周,显著短于对照组(8.2±0.9)周(t=-10.851,P=0.000)。观察组治疗后2周、1个月、3个月疼痛VAS评分明显低于对照组(P<0.05),2组末次随访疼痛VAS评分无统计学差异(P>0.05);ODI和JOA评分组间、时间和组间与时间的交互作用差异均有显著性(P<0.05)。28例随访12~24个月,平均13.7月,观察组和治疗组末次随访改良MacNab疗效优良率分别为93.3%(14/15)、76.9%(10/13),差异无显著性(Z=-1.270,P=0.204)。结论椎间孔镜技术辅助抗生素治疗腰椎间隙感染简便,创伤小,是一种安全有效的方法。
Objective To explore the efficacy of percutaneous transforaminal endoscopic surgery in the treatment of lumbar intervertebral infections.Methods A retrospective analysis was made on 28 cases of patients with lumbar intervertebral infections in our hospital from November 2010 to April 2017.The observation group(n=15)was treated with percutaneous transforaminal endoscopic surgery combined with antibacterial therapy.The control group(n=13)was given injection of antibiotics and conservative bed rest.The Visual Analogue Scale(VAS),Japanese Orthopaedic Association(JOA)score,and Oswestry Disability Index(ODI)were compared at preoperation,2 weeks,1 month,and 3 months after operation,and the last follow-up between the two groups.The modified MacNab criteria was used to evaluate the efficacy at the end of the follow-up.Results The time of disappearance of pain in the control group was(7.1±0.7)weeks,which was longer than(3.6±1.3)weeks in the observation group,with significant different(t=-8.645,P=0.000).The time of normal erythrocyte sedimentation rate in the control group was(9.8±1.1)weeks,which was longer than(4.4±1.7)weeks in the observation group,and the time of negative C-reactive protein in the control group was(8.2±0.9)weeks,which was longer than(3.6±1.3)weeks in the observation group(t=-10.134,P=0.000;t=-10.851,P=0.000).The VAS scores of pain in the observation group was significantly lower than that in the control group at 2 weeks,1 month and 3 months after treatment(P<0.05).There was no significant difference between the two groups at the last follow-up(P>0.05).There were significant differences in the ODI and JOA scores among groups,at different time points within groups,and interaction between groups and time(P<0.05).All the 28 cases were followed up for 12-24 months,with an average of 13.7 months.According to the modified MacNab criteria,the overall excellent and good rate in the observation group and the control group were 93.3%(14/15)and 76.9%(10/13),respectively.There was no significant difference(Z=-1.270,P=0.204).ConclusionCombined with antibacterial therapy,percutaneous transforaminal endoscopic surgery to treat lumbar intervertebral space infections is a safe and effective method.
作者
唐建华
赵丽丽
黄春明
钟诚凡
刘付仟
Tang Jianhua;Zhao Lili;Huang Chunming(Department of Orthopedics, Gaozhou People’s Hospiital, Gaozhou 525200, China)
出处
《中国微创外科杂志》
CSCD
北大核心
2020年第5期446-450,共5页
Chinese Journal of Minimally Invasive Surgery
基金
2018年茂名市科技计划项目(2018202)。
关键词
椎间孔镜技术
腰椎间隙感染
Transforaminal endoscopic surgery
Lumber intervertebral infection
