摘要
目的研究经皮骶2髂骨三皮质螺钉(S2AI)治疗老年无神经症状下腰椎椎间盘炎近期疗效。方法回顾性分析28例于沈阳军区总医院骨科脊柱病区接受S2AI内固定术的无神经症状的下腰椎椎间盘炎患者,所有患者均由同一术者完成,共完成56枚经皮S2AI内固定术,年龄71~79岁,所有病变节段均为L4~L5和L5~S1节段,术后平均随访时间6.67个月,分析本组患者的平均手术时间、术中失血量、术后下床时间、平均住院日、术后切口愈合情况,并比较分析术前、术后1周、术后6个月的Oswestry功能评分、目测类比评分、红细胞沉降率、C反应蛋白,并通过复查术后CT分析内固定松动情况。结果本组患者平均手术时间为(158.12±4.32)min、术中平均失血量为(25.34±3.23)ml、术后平均下床时间为(1.34±0.35)d、平均住院日为(7.29±1.34)d、术后仅有1例患者出现切口S2AI切口愈合不良,术后切口愈合率为96.42%,1例患者右侧S2AI螺钉出现松动,螺钉松动率为1.79%;术后1周和6个月Oswestry功能评分分别为32.21和23.2,且与术前比较P值均<0.05;术后1周和6个月目测类比评分分别为2.17和1.25,且与术前目测类比评分比较P值均<0.05,术后1周和6个月红细胞沉降率和C反应蛋白分别为15.32 mm/h、7.89 mg/L和14.56 mm/h、8.9 mg/L,且与术前比较P值均<0.05。结论经皮S2AI内固定术具有创伤小、失血少、术后下床时间早,且能够明显改善无神经症状下腰椎椎间盘炎的症状等优点,具有良好的近期临床疗效。
Objective To evaluate the short-term efficacy of percutaneous $2-alar-iliac screw （S2AIS） fixation for the treatment of lower lumbar spondylodiscitis with no neurological symptoms in elderly patients. Methods The clinical data of 28 patients of lower lumbar spondylodiscitis with no neurological symptoms, who were admitted to the Ward of Spine, Department of Orthopaedics, General Hospital of Shenyang Military Region, China, to receive percutaneous S2AIS fixation, were retrospectively analyzed. The operation was performed by the same surgeon for all patients. A total of 56 S2AIS fixation procedures were accomplished. The patients＇ age varied from 71 to 79 years old. The spondylodiscitis was located at IA- L5 or L5-S1. After the treatment, the patients were followed up for a mean of 6.67 months. The mean operative time, the amount of intraoperative blood loss, the postoperative bed time, the average hospitalization days and the postoperative wound healing were documented and analyzed. The Oswestry score, visual analogue score, erythrocyte sedimentation rate, C reactive protein level were determined before operation as well as at one week and 6 months after operation, and postoperative CT was performed to check the loosening of internal screw fixation. The results were compared and analyzed. Results The mean operative time was （158.12±4.32） min, the average amount of intraoperative blood loss was （25.34±3.23） ml, the average postoperative bed time was （1.34±0.35） d, and the average hospitalization time was （7.29±1.34） d. Poor surgical incision healing was seen in only one patient, and the postoperative wound healing rate was up to 96.42%. Loosening of right S2AIS was detected in one patient, with the screw loosening rate being 1.79%. The Oswestry scores determined at one week and 6 months after treatment were 32.21 and 23.20 respectively, which were significantly different from the preoperative score （P〈0.05）. The visual analogue scores determined at one week and 6 months after treatme
出处
《介入放射学杂志》
CSCD
北大核心
2018年第1期53-57,共5页
Journal of Interventional Radiology
关键词
椎间盘炎
脊柱微创固定
骶骨骨盆内固定
髂骨螺钉
经皮骶2髂骨三皮质螺钉
spondylodiscitis
minimally-invasive spine stabilization
sacropelvic fixation
iliac screw
percutaneous S2-alar-iliac screw
