摘要
目的探讨单纯经皮椎弓根螺钉微创治疗轻度胸腰椎结核的疗效。方法 2014年2月～2017年2月我科对31例单节段轻度胸腰椎结核,穿刺取出病灶并活检,采用病灶椎体经皮椎弓根螺钉内固定术,术后继续系统抗结核药物治疗12～18个月。结果 31例顺利完成手术,术中穿刺取得的病灶组织行病理检查均提示干酪样坏死,符合结核改变。手术时间70～100 min,(82. 3±9. 0) min;出血量30～50 ml,平均40 ml;术后住院时间为7～10 d,(7. 7±1. 0) d。无手术并发症发生。31例随访12～36个月,(27. 3±4. 3)月,31例均达到骨质融合,无结核复发征象,无内固定松动、断裂征象。术前、术后1个月、末次随访VAS评分分别为(7. 2±0. 9)、(4. 0±0. 7)、(2. 0±0. 6)分,不同时点两两比较P均=0. 000。术前、术后1个月、末次随访ODI分别为(65. 2±9. 1)%、(41. 2±5. 8)%、(20. 3±2. 9)%,不同时点两两比较P均=0. 000。术前、术后1周、末次随访后凸Cobb角分别为7. 5°±1. 2°、5. 5°±1. 2°、6. 6°±1. 5°,术前与末次随访P=0. 001,其余时点两两比较P均=0. 000。术前、术后1个月、末次随访红细胞沉降率分别为(62. 8±18. 2)、(39. 4±10. 2)、(14. 2±3. 5) mm/h,不同时点两两比较P均=0. 000。结论单纯经皮椎弓根螺钉固定对轻度胸腰椎结核有较好的疗效,是一种简单、有效的微创治疗方式。
Objective To explore clinical effects of simple fixation with percutaneous pedicle screw for the treatment of mild thoracolumbar tuberculosis.Methods A total of 31 patients diagnosed with one segment mild thoracolumbar tuberculosis from February 2014 to February 2017 were analyzed retrospectively.Biopsy had been performed by puncture firstly.All the cases underwent percutaneous pedicle screw fixation for the infective vertebrae.After operation,they were systematically and routinely treated with anti-tuberculous medications for 12-18 months.Results All the surgical procedures were performed successfully.The lesions punctured during operation were proceeded by pathological examination and conformed to tuberculosis.The operation time was 70-100 min(mean,82.3±9.0 min),the amount of bleeding was 30-50 ml(mean,40.0 ml),and the postoperative length of stay was 7-10 d(mean,7.7±1.0 d).There was no intraoperative complication.The patients were followed up for 12-36 months(mean,27.3 months).Interbody fusion was obtained in all of them.There were no instances of spinal tuberculosis recurrence and signs of implant failure at the final follow-up.In terms of VAS scores,the data at preoperation,1 month after surgery,and the final follow-up were(7.2±0.9),(4.0±0.7),and(2.0±0.6)points,respectively.In terms of ODI,the data at preoperation,1 month after surgery,and the final follow-up were(65.2±9.1)%,(41.2±5.8)%,and(20.3±2.9)%,respectively.In terms of Cobb angle of kyphosis,the data at preoperation,1 week after surgery,and the final follow-up were 7.5°±1.2°,5.5°±1.2°,and 6.6°±1.5°,respectively.In terms of ESR,the data at preoperation,1 month after surgery,and the final follow-up were(62.8±18.2),(39.4±10.2),and(14.2±3.5)mm/h,respectively.As compared with preoperative levels,the VAS scores,ODI and ESR decreased significantly both at 1 month after surgery and the final follow-up(the values of P were all 0.000).In terms of Cobb angle of kyphosis,as compared with preoperative levels,the data at 1 week after surgery and
作者
徐准
王程
王文军
晏怡果
薛静波
李学林
王明
Xu Zhun;Wang Cheng;Wang Wenjun(Department of Spine Surgery,First Affiliated Hospital of University of South China,Hengyang 421001,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第12期1103-1107,共5页
Chinese Journal of Minimally Invasive Surgery
基金
湖南省卫生计生委科研计划课题项目(C20180213
B20180154)
湖南省卫生计生委科研计划课题重点项目(A2017016)
关键词
经皮椎弓根螺钉
胸腰椎结核
Percutaneous pedicle screw
Thoracolumbar tuberculosis
