摘要
目的探讨前路小切口在胸腰椎结核病灶清除、植骨融合内固定术的运用效果。方法本研究选择2015年1月~2019年12月于本院收治的64例胸腰椎结核患者,采用随机数字表法均分为对照组与观察组,对照组采用常规前后路联合手术,观察组采用前路小切口结核病灶清除、植骨融合联合后路内固定术治疗。比较两组患者围术期手术相关指标,术前、术后1d、3个月、末次随访时评价疼痛VAS评分,检测红细胞沉降率(erythrocyte sedimentation rate,ESR),测量后凸Cobb角;术前、末次随访时,比较两组美国脊柱损伤协会(American spinal injury association,ASIA)分级,比较Bridwell骨融合分级。结果观察组切口长度、手术时间、术中出血量等数据显著低于对照组,差异有统计学意义(P<0.05);两组随访时间差异无统计学意义(P>0.05);术后1 d、3个月、末次随访时的ESR、VAS评分、Cobb角等数据均显著低于术前(P<0.05),观察组术后1 d的VAS评分显著低于对照组(P<0.05);两组末次随访时的ASIA分级较术前均显著改善(P<0.05),但组间差异无统计学意义(P>0.05);两组Bridwell骨融合分级差异无统计学意义(P>0.05)。结论前路小切口与常规前路切口用于胸腰椎结核病灶清除、植骨融合内固定,均能够有效减轻疼痛症状,纠正脊柱后凸畸形,改善脊柱功能,但小切口能够有效减轻手术创伤、加快术后康复。
Objective To explore the application effect of small anterior incision in debridement of thoracolumbar tuberculosis,bone graft fusion and internal fixation.Methods Sixty-four patients with thoracolumbar tuberculosis in our hospital from January 2015 to December 2019 were selected,and they were divided into the control group and the observation group by the digital table method.The control group was treated with conventional anterior and posterior combined surgery,and the observation group was treated with anterior small incision tuberculosis lesion removal,bone graft fusion combined with posterior internal fixation.The perioperative surgical indicators between the two groups were compared.The VAS scale of pain before operation,1 d,3 months after operation,and at the last follow-up were evaluated.The erythrocyte sedimentation rate(ESR)was detected.The kyphotic Cobb angle was measured.The American spinal injury association(ASIA)classification between the two groups before surgery and at the last follow-up was compared.The Bridwell bone fusion grades were compared.Results The length of incision,operation time and intraoperative blood loss in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in follow-up time between the two groups(P>0.05).Compared with before operation,the ESR,VAS score and Cobb angle were significantly decreased at 1 d,3 months after operation and at the last follow-up(P<0.05).At 1 day after operation,the VAS score of the observation group was significantly lower than that of the control group(P<0.05).The ASIA grading at the last follow-up of the two groups was significantly improved compared with before operation(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).There was no statistically significant difference in Bridwell bone fusion grading between the two groups(P>0.05).Conclusion Anterior small incisions and conventional anterior incisions for debridement of thoracolumbar tubercu
作者
卢波
樊强
代银洪
LU Bo;FAN Qiang;DAI Yin-hong(Department of Orthopedics,Sichuan Modern Hospital,Chengdu,Sichuan 610041,China)
出处
《颈腰痛杂志》
2021年第5期643-646,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
前路小切口
胸腰椎结核
病灶清除
植骨融合
后路内固定
anterior small incision
thoracolumbar tuberculosis
focus clearance
bone graft fusion
posterior internal fixation
