| Ⅰ期经后路病灶清除脊柱内固定术治疗腰椎布鲁杆菌性脊柱炎 |
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投稿时间：2023-09-12
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| 作者 | Author | 单位 | Address | E-Mail |
| 寇贤帅 |
KOU Xian-shuai |
甘肃中医药大学第一临床医学院 甘肃省人民医院, 甘肃 兰州 730000 |
The First Clinical Medical College, Gansu University of Chinese Medicine, Gansu Provincial Hospita, Lanzhou 730000, Gansu, China |
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| 舍炜 |
SHE Wei |
甘肃省人民医院骨科, 甘肃 兰州 730000 |
Department of Orthopaedics, Gansu Provincial Hospital, Lanzhou 730000, Gansu, China |
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| 马贵福 |
MA Gui-fu |
甘肃省人民医院骨科, 甘肃 兰州 730000 |
Department of Orthopaedics, Gansu Provincial Hospital, Lanzhou 730000, Gansu, China |
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| 普星宇 |
PU Xing-yu |
甘肃省人民医院骨科, 甘肃 兰州 730000 |
Department of Orthopaedics, Gansu Provincial Hospital, Lanzhou 730000, Gansu, China |
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| 吴云彪 |
WU Yun-biao |
甘肃中医药大学第一临床医学院 甘肃省人民医院, 甘肃 兰州 730000 |
The First Clinical Medical College, Gansu University of Chinese Medicine, Gansu Provincial Hospita, Lanzhou 730000, Gansu, China |
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| 祁阳 |
QI Yang |
甘肃中医药大学第一临床医学院 甘肃省人民医院, 甘肃 兰州 730000 |
The First Clinical Medical College, Gansu University of Chinese Medicine, Gansu Provincial Hospita, Lanzhou 730000, Gansu, China |
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| 骆文远 |
LUO Wen-yuan |
甘肃省人民医院骨科, 甘肃 兰州 730000 |
Department of Orthopaedics, Gansu Provincial Hospital, Lanzhou 730000, Gansu, China |
LWY2656@163.com |
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| 期刊信息：《中国骨伤》2024年，第37卷，第8期，第764-771页 |
| DOI：10.12200/j.issn.1003-0034.20230255 |
| 基金项目:甘肃省人民医院优秀硕士生培育计划项目(编号:22GSSYD-47);甘肃中医药大学研究生"创新之星"项目(编号:2023CXZX-756);甘肃省人民医院院内基金项目(编号:18GSSY5-11) |
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中文摘要:
目的：探讨Ⅰ期行后路病灶清除脊柱内固定术在腰椎布鲁菌病性脊柱炎患者中的临床疗效及安全性。
方法：对2017年10月至2022年10月收治的腰椎布鲁菌病性脊柱炎24例患者临床资料进行回顾分析,2例术后10个月失语,最终纳入22例,男13例,女9例,年龄33~63(52.00±6.89)岁,行Ⅰ期后路病灶清除、脊柱内固定术治疗。记录患者手术时间、术中出血量、随访时间、手术前后红细胞沉降率(erythrocyte sedimentation rate,ESR)及C反应蛋白(C-creactive protein,CRP);采用痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)、神经功能日本骨科协会(Japanese Orthopedic Association,JOA)评分、美国脊髓损伤学会(American Spinal Injury Assciation,ASIA)脊髓损伤分级和改良Macnab标准评价疗效。
结果：22例患者获得随访,时间12~30(17.41±4.45)个月,手术时间70~155(116.59±24.32) min;术中出血量120~520(275.00±97.53) ml。术后1周及末次随访时CRP、ESR、水平较术前均下降(P<0.05)。术后1周及末次随访时VAS、JOA评分及ODI评分均较术前明显改善(P<0.05)。ASIA脊髓损伤分级术前与术后1周差异无统计学意义(P=0.18),术前与末次随访的差异有统计学意义(P<0.05)。末次随访改良MacNab疗效优21例,可1例,且随访期间均无复发。
结论：Ⅰ期经后路病灶清除、脊柱内固定术,切口少、手术时间短,有助于神经功能恢复,预后符合临床要求,能够有效控制布鲁菌病性脊柱炎。 |
| 【关键词】腰椎 布鲁菌病病 病灶清除 脊柱内固定术 |
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| One-stage posterior debridement and spinal internal fixation for the treatment of lumbar Brucellar spondylitis |
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ABSTRACT
Objective To explore the clinical efficacy and safety of one-stage posterior lesion removal and internal spinal fixation in patients with lumbar Brucellosis spondylitis.
Methods The clinical data of 24 patients admitted from October 2017 to October 2022 were retrospectively analyzed,2 patients were lost to follow-up at 10 months after surgery,at the final 22 cases were included in the study,including 13 males and 9 females with an average age of (52.00±6.89) years old,were treated with one-stage posterior lesion removal and internal spinal fixation. The operation time,intraoperative bleeding,follow-up time,erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) before and after operation were recorded. The pain visual analogue scale(VAS),Oswestry disability index(ODI),the Japanese Orthopaedic Association(JOA) score for neurofunction,American Spinal Injury Association(ASIA) spinal cord injury grade and modified MacNab criteria were ussed to evaluate the efficacy.
Results All patients were followed up from 12 to 30 months with an average of (17.41±4.45) months. The operation time was 70 to 155 min with an average of (116.59±24.32) min;the intraoperative bleeding volume was 120 to 520 ml with an average of (275.00±97.53) ml. CRP and ESR levels decreased more significantly at 1 week and at the final follow-up than preoperative levels(P<0.05). VAS,JOA score and ODI at 1 week and at the latest follow-up were more significantly improved than preoperative results(P<0.05). There was no significant difference between ASIA preoperative and 1 week after operation(P>0.05),and a significant difference between preoperative and last follow-up(P<0.05). In the final follow-up,21 patients had excellent efficacy,1 patient had fair,and there was no recurrence during the follow-up.
Conclusion One-stage transpedicular lesion removal and internal spinal fixation, with few incisions and short operation time, helps the recovery of neurological function,and the prognosis meets the clinical requirements,which can effectively control Brucella spondylitis. Brucellosis; Debridement; Spinal internal fixation |
| KEY WORDS Lumbar vertebrae Brucellosis Debridement Spinal internal fixation |
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| 中文格式: | 寇贤帅,舍炜,马贵福,普星宇,吴云彪,祁阳,骆文远.Ⅰ期经后路病灶清除脊柱内固定术治疗腰椎布鲁杆菌性脊柱炎[J].中国骨伤,2024,37(8):764~771 |
| 英文格式: | KOU Xian-shuai,SHE Wei,MA Gui-fu,PU Xing-yu,WU Yun-biao,QI Yang,LUO Wen-yuan.One-stage posterior debridement and spinal internal fixation for the treatment of lumbar Brucellar spondylitis[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(8):764~771 |
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