摘要
目的评估椎间孔镜联合后路经皮椎弓根螺钉,结合链霉素硫酸钙人工骨治疗腰椎结核1年后的疗效。方法回顾性分析2016年7月至2020年6月在广西中医药大学第一附属医院行手术治疗的52例腰椎结核患者。随访时间最短12个月,最长20个月,平均随访(15.10±1.37)个月,最终纳入有效病例50例,根据手术的方式选择,将患者分为A组(椎间孔镜下结核病灶清除后椎间隙植入载链霉素硫酸钙人工骨联合后路经皮椎弓根螺钉内固定术)32例和B组(前后联合入路下病灶清除植骨融合内固定术12例,后路病灶清除植骨融合内固定术6例)18例。对两组相关指标进行分析。结果52例病例随访过程中,脱落病例2例(1例病例死亡、1例病例自动退出),最终纳入有效病例50例。终末随访时两组间在年龄、性别、ESR、CRP、Cobb角、VAS、JOA、ODI评分、ASIA分级方面比较,差异无统计学意义(P>0.05)。两组间在手术时间、术中出血量、下床时间、住院时间方面比较差异有统计学意义(P<0.05)。结论相比传统手术行前路、后路、前后联合入路治疗腰椎结核,后外侧椎间孔镜下置入载链霉素硫酸钙人工骨联合后路经皮椎弓根螺钉内固定治疗腰椎结核,同样可以达到满意临床效果,同时载链霉素硫酸钙人工骨可以起到缓慢释放药物、提高病灶局部链霉素药物浓度,起到强效杀菌作用,又具有创伤小、恢复快等优势,并且可以达到充分减压、清除病灶组织及达到骨性融合重建脊柱稳定性的目的。
Objective To further evaluate the efficacy of foraminal lens combined with posterior percutaneous pedicle screw and streptomycin calcium sulfate artificial bone in the treatment of lumbar tuberculosis in the 1-year follow-up.Methods Data of fifty-two patients with lumbar tuberculosis who received surgical treatment in the First Affiliated Hospital of Guangxi University of Chinese Medicine from July 2016 to June 2020 were retrospectively analyzed.The follow-up time ranged from 12 months to 20 months,with an average of(14.08±1.27)months,and 50 effective cases were finally included.According to the method of operation,the patients were divided into group A(32 cases treated with foraminal lens combined with posterior percutaneous pedicle screw and streptomycin calcium sulfate artificial bone)and group B(18 cases treated with)A comparative study was conducted in terms of related indicators in the two groups.Results In the follow-up of 52 cases,2 cases were shed(1 case died,1 withdrew automatically),and 50 effective cases were eventually included.Comparison of age,sex,ESR,CRP,Cobb Angle,VAS,JOA,ODI score and ASIA grade between the two groups at the end of follow-up(P>0.05)indicated no significant difference but comparison of operative time,intraoperative blood loss,time out of bed and length of stay between the two groups(P<0.05)indicated statistical significance.Conclusion Compared to traditional anterior,posterior or combined anterior and posterior surgery for lumbar spinal tuberculosis,foraminal lens combined with posterior percutaneous pedicle screw and streptomycin calcium sulfate artificial bone in the treatment of lumbar tuberculosis,can also achieve satisfactory clinical effect.Streptomycin sulfate artificial bone helps to slowly release drugs and improve local drug concentration streptomycin lesions for a strong bactericidal effect.It also has the advantages of small trauma and quick recovery.In addition,it achieves the purpose of decompression,removal of lesion tissue and reconstruction of spinal stability b
作者
付拴虎
钟远鸣
卢大汉
覃浩然
伍亮
陈勇喜
许伟
覃海飚
FU Shuanhu;ZHONG Yuanming;LU Dahan;QIN Haoran;WU Liang;CHEN Yongxi;XU Wei;QIN Haibiao(The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2022年第8期974-979,共6页
The Journal of Practical Medicine
基金
国家自然科学基金项目(编号:81760874)
广西重点研发计划项目(编号:桂科AB20159018)
广西壮族自治区卫生健康委员会(编号:Z20210147)
广西中医药大学2020年博士研究生科研创新项目(编号:YCBSZ2020001)。
关键词
椎间孔镜
载链霉素硫酸钙人工骨
经皮钉
腰椎结核
foraminal lens
calcium sulfate artificial bone loaded with streptomycin
percutaneous screw
lumbar tuberculosis
