| 皮质骨轨迹螺钉技术在老年腰椎结核中的应用 |
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摘要点击次数: 1977
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投稿时间：2018-03-12
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| 作者 | Author | 单位 | Address | E-Mail |
| 应小樟 |
YING Xiao-zhang |
浙江省中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Province, Hangzhou 310003, Zhejiang, China |
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| 石仕元 |
SHI Shi-yuan |
浙江省中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Province, Hangzhou 310003, Zhejiang, China |
ssylf@xs.hz.zj.cn |
| 郑琦 |
ZHENG Qi |
浙江省中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Province, Hangzhou 310003, Zhejiang, China |
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| 朱博 |
ZHU Bo |
浙江省中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Province, Hangzhou 310003, Zhejiang, China |
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| 金阳辉 |
JIN Yang-hui |
浙江省中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Province, Hangzhou 310003, Zhejiang, China |
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| 郑铭锋 |
ZHENG Ming-feng |
浙江省中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Province, Hangzhou 310003, Zhejiang, China |
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| 期刊信息：《中国骨伤》2018年，第31卷，第11期，第1012-1016页 |
| DOI：10.3969/j.issn.1003-0034.2018.11.006 |
| 基金项目:浙江省医药卫生科技计划项目（编号：2018KY605）；杭州市农业和社会发展研究主动设计项目（编号：20180417A04） |
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中文摘要:
目的：探讨老年腰椎结核Ⅰ期行皮质骨轨迹（cortical bone trajectory，CBT）螺钉技术联合前路小切口病灶清除支撑植骨的临床疗效。
方法：对2015年2月至2016年12月采用CBT螺钉技术联合前路小切口病灶清除治疗的22例腰椎结核患者进行回顾性分析，其中男13例，女9例，年龄（73.3±7.1）岁。Frankel分级：B级2例，C级5例，D级6例，E级9例。对手术前后视觉模拟评分（VAS）、Cobb角、红细胞沉降率（ESR）、Frankel分级进行分析，并观察手术并发症、内植物稳定性和植骨融合情况。
结果：22例患者均获得随访，时间12~24（18.7±4.6）个月。有2例患者术后3个月发现前路手术对侧腰大肌脓肿增大，行B超定位下置管引流后治愈。余20例均Ⅰ期愈合，无窦道形成及脊柱结核复发。末次随访Frankel分级：C级3例，D级5例，E级14例。末次随访后凸Cobb角由术前的（17.68±3.86）°减少至（4.77±2.47）°；VAS评分由术前的（6.95±2.26）分减少至末次随访时的（2.18±1.59）分；ESR由术前的（47.14±20.85）mm/h降至末次随访的（16.77±11.42）mm/h。X线、CT检查均提示已骨性愈合，平均融合时间为（4.9±1.2）个月。
结论：采用Ⅰ期皮质骨轨迹螺钉技术联合前路小切口病灶清除支撑植骨治疗老年腰椎结核是较为有效、安全的方法。 |
| 【关键词】脊柱结核 皮质骨轨迹 脊柱融合术 骨移植 |
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| Application of cortical bone trajectory screw in elderly patients with lumbar tuberculosis |
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ABSTRACT
Objective: To explore the clinical effect of cortical bone trajectory screw technology combined with anterior mini-open debridement and prop graft for lumbar tuberculosis in elderly.
Methods: The clinical data of 22 patients with lumbar tuberculosis treated by cortical bone trajectory screw technology combined with anterior mini-open debridement and prop graft from February 2015 to December 2016 were retrospectively analyzed. There were 13 males and 9 females with an average age of (73.3±7.1) years old. The pre-operative Frankel grading showed that 2 cases were grade B, 5 cases were grade C, 6 were grade D, and 9 were grade E. Pre-and post-operative kyphosis Cobb angle, visual analogue scale (VAS), erythrocyte sedimentation rate (ESR) and the Frankel grade were analyzed, the conditions of complication, stability of internal plants, graft fusion were observed.
Results: All 22 patients were follow-up for 12 to 24 months with an average of (18.7±4.6) years. Two patients with contralateral psoas major muscle abscess enlarged at 3 months after operation and were cured by drainage under the guidance of type-B ultrasonic. Other 20 cases got primary healing without sinus formation and recurrence of spinal tuberculosis. At the final follow-up, the Frankel grading showed that 3 cases was grade C, 5 cases were grade D, and 14 cases were grade E. The Cobb angle, visual analogue scale (VAS), ESR were respectively decreased from preoperative (17.68±3.86)°, (6.95±2.26) points, (47.14±20.85)mm/h to (4.77±2.47)°, (2.18±1.59) points, (16.77±11.42) mm/h at final follow-up. X-ray and CT scan showed bone union for 3 to 8 months after operation, with a mean time of (4.9±1.2) months.
Conclusion: It is effective method to treat lumbar tuberculosis with cortical bone trajectory screw technology combined with anterior mini-open debridement and prop graft. |
| KEY WORDS Spinal tuberculosis Cortical bone trajectory Spinal fusion Bone transplantation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 应小樟,石仕元,郑琦,朱博,金阳辉,郑铭锋.皮质骨轨迹螺钉技术在老年腰椎结核中的应用[J].中国骨伤,2018,31(11):1012~1016 |
| 英文格式: | YING Xiao-zhang,SHI Shi-yuan,ZHENG Qi,ZHU Bo,JIN Yang-hui,ZHENG Ming-feng.Application of cortical bone trajectory screw in elderly patients with lumbar tuberculosis[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(11):1012~1016 |
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