摘要
目的探讨斜前方人路腰椎椎间融合术治疗腰椎布鲁杆菌性脊柱炎的临床效果。方法回顾性分析2015年3月至2017年10月青岛市胸科医院收治的行斜前方人路腰椎椎间融合术治疗的腰椎布鲁杆菌性脊柱炎20例，分析其临床症状、手术时间、出血量、并发症、治疗转归、植骨融合的情况，以及手术前后视觉模拟评分法（VAS）评分、白细胞（WBC）、血红细胞沉降率（ESR）、C-反应蛋白（CRP）检测水平的变化情况。结果本组手术中时间40-90min，平均（65．00±8．21）min；出血量200-400ml，平均（290．53±37．25）ml。在手术显露过程中出现腹膜损伤1例，术中给予修补；腰椎4～5手术导致交感神经链损伤1例，术后对侧神经根疼痛再手术1例，均治愈。末次随访VAS评分[（1．31±0．96）分]、WBC[（4．56±1．02）×10^9／L]、ESR[（25．53±3．56）mm／1hl、CRP[（13．61±7．65）mg／L]较术前[分别为（7．43±1.07）分，（9．65±2．38）×10^9／L，（81．22±12．27）mm／1h，（59．08±20．39）mg／L]明显改善（t=29．37，P=0．000；t=12．49，P=0．034；t=39．93，P=0．000；t=15．82，P=0．008）。术后随访6～18个月，无1例复发，20例植骨融合均满意。结论斜前方人路腰椎椎间融合术创伤小、出血少、康复快，是治疗腰椎布鲁杆菌性脊柱炎理想的微创技术。
Objective To explore the clinical value of anterior oblique lumber interbody fusion in the treat- ment of lumbar Brucellar spondylitis. Methods A retrospective analysis of 20 cases of lumbar Brucellar spondylitis treated by anterior oblique lumber interbody fusion from March 2015 to October 2017 was studied. The clinical symptoms, operative time, bleeding volume, complications, outcome, and bone graft fusion were investigated. The visual analogue score （VAS）, white blood cells （WBC）, erythrocyte sedimentation rate （ESR）, and C-reactive protein （CRP） before and after the operation were also analyzed. Results The operation time of the anterior opera- tion was 40-90 minutes, with an average of （65.00±8. 21） rain; the amount of bleeding was 200-400 ml, with an average of （290. 53±37.25） ml. One ease had peritoneal injury during exposure and received intraoperative repair; 1 case had sympathetic nerve injury resulted from lumbar 4/5 operation, 1 case had reoperation for post-operative contralateral nerve root pain, all were cured. The last follow-up VAS score （1.31±0. 96; t=29.37, P：0. 000）, WBC （4.56±1.02）x10^9/L; t=12.49, P=0. 034）, ESR （（25.53±3.56） mm/1 h; t=39.93, P=0. 000）, and CRP （13.61 ± 7.65） mg/L; t=15.82, P= 0. 008） were significantly improved compared with the preoperative VAS score （7.43±1.07）, WBC （（9.65±2.38）X 10^9/L）, ESR （（81.22±12.27） mm/1 h）, and CRP （（59.08± 20.39） mg/L）. Follow up for 6 to 18 months, no recurrence occurred, and 20 cases were satisfied with bone graft fusion. Conclusion Lumbar interbody fusion with anterior oblique approach is an ideal minimally invasive technique for lumbar Brucellar spondylitis with less trauma, less bleeding, and rapid recovery.
作者
赵明伟
周伟东
胡全君
李磊
张明磊
刘朝阳
ZHAO Ming- wei , ZHOU Wei-dong , HU Quan-jun , L1 Lei , ZHANG Ming-lei , LIU Zhao-yang(Department of Surgery, Qingdao Chest Hospital, Qingdao 266043, Chin)
出处
《中国防痨杂志》
CAS
2018年第5期485-489,共5页
Chinese Journal of Antituberculosis
基金
山东省卫生和计划生育委员会科研项目（2015WS0320）
青岛市医疗卫生优秀人才培养项目
关键词
布鲁杆菌病
脊柱炎
脊柱融合术
外科手术
微创性
治疗结果
Brucellosis
Spondylitis
Spinal fusion
Surgical procedures
Minimally invasive
Treatment outcome
