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手术和保守治疗腰椎间盘术后椎间盘炎疗效的病例对照研究
Hits: 2524   Download times: 394   Received:February 15, 2012    
作者Author单位UnitE-Mail
车立新 CHE Li-xin 新疆维吾尔自治区人民医院骨二科, 新疆 乌鲁木齐 830001 xin163jiang@163.com 
依力哈尔·沙迪克 Yili-haer·Sha-di-ke 新疆维吾尔自治区人民医院骨二科, 新疆 乌鲁木齐 830001  
谢淑萍 XIE Shu-ping 武警新疆总队乌鲁木齐市支队卫生队, 新疆 乌鲁木齐 830000  
程新平 CHENG Xin-ping 新疆维吾尔自治区人民医院骨二科, 新疆 乌鲁木齐 830001  
期刊信息:《中国骨伤》2012年25卷,第8期,第670-673页
DOI:10.3969/j.issn.1003-0034.2012.08.014


目的:比较手术和保守治疗腰椎间盘术后椎间盘炎的疗效。

方法:对2004年1月至2009年1月收治的41例腰椎间盘术后椎间盘炎患者进行回顾性分析,其中男17例,女24例;年龄37~68岁,平均53.6岁。其中手术治疗19例(手术组),保守治疗22例(保守组).记录患者一般情况、临床特征、影像学资料、实验室检查结果、抗生素使用情况、住院时间、后遗症等,并进行比较分析。临床疗效采用VAS(visual analogue scales,VAS)评分系统和Oswestry功能障碍指数(Oswestry disability index,ODI)进行评定。

结果:所有患者均获随访,时间25~40个月,平均31个月。影像学提示植骨融合良好,未出现椎间盘炎复发。与治疗前相比,治疗后1个月、1年及2年VAS评分及ODI指数均有明显改善(P<0.01);组间比较,1个月时手术组VAS及ODI优于保守治疗组(P<0.01),治疗后1年及2年时这2项指标间的差异无统计学意义(P>0.05).

结论:椎间盘术后并发椎间盘炎,需积极治疗,保守治疗和手术治疗均是有效的治疗方法。短期内手术疗效优于保守治疗,但长期随访显示保守治疗也可达到满意疗效。
[关键词]:椎间盘炎  外科手术  椎间盘
 
Comparison between surgical and conservative treatment for postoperative lumbar discitis
Abstract:

Objective:To compare therapeutic effects between surgical and conservative treatment for postoperative lumbar discitis.

Methods:From January 2004 to January 2009,41 patients(17 males and 24 females ranging the age from 37 to 68 years with an average of 53.6 years) with postoperative lumbar discitis were retrospectively studied and divided into two groups. There were 19 patients in operation group,22 patients in conservative group. Clinical data and features,image data,laboratory examinations,antibiotics utilization,hospital stays and sequelae were recorded and analyzed. Visual analogue scales system(VAS) and Oswestry disability index (ODI) were applied to evaluate therapeutic effects.

Results:All patients were followed up over 2 years. Imaging revealed good bone fusion and no occurrence of discitis. VAS score and ODI at 1 month,1 year and 2 years were significantly improved after treatment(P<0.01). While VAS and ODI in operation group at 1 month were improved more than that of conservative group(P<0.01),and there was no significant difference between two groups at 1 year and 2 years(P>0.01).

Conclusion:Surgical and conservative treatment for postoperative lumbar discitis is effective. Surgical treatment is superior to conservative treatment in a short time,while conservative treatment can achieve long-term satisfactory curative effects.
KEYWORDS:Discitis  Surgical procedure,operative  Intervertebral disk
 
引用本文,请按以下格式著录参考文献:
中文格式:车立新,依力哈尔·沙迪克,谢淑萍,程新平.手术和保守治疗腰椎间盘术后椎间盘炎疗效的病例对照研究[J].中国骨伤,2012,25(8):670~673
英文格式:CHE Li-xin,Yili-haer·Sha-di-ke,XIE Shu-ping,CHENG Xin-ping.Comparison between surgical and conservative treatment for postoperative lumbar discitis[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(8):670~673
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