微创侧路病灶清除融合内固定治疗腰椎结核  

Debridement,Bone Autograft and Internal Fixation via Minimally Invasive Lateral Approach for Lumbar Spine Tuberculosis

作　　者：甘锋平[1] 谭海涛[1] 江建中[1] 谢兆林[1] 陈国平[1] 詹翼[1] 

机构地区：[1]广西贵港市人民医院骨科,贵港537100

出　　处：《中国微创外科杂志》2015年第7期624-627,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨微创侧方入路病灶清除椎间融合术治疗腰椎结核的疗效。方法回顾性分析2013年1月-2014年6月15例腰椎结核患者的资料,男6例,女9例,年龄25-72岁,平均48.5岁。受累节段均为单间隙2个椎体,发病部位L2/36例,L3/45例,L4/54例。采用微创通道下病灶清除、植骨骨融合内固定治疗。术后应用异烟肼、利福平、乙胺丁醇、吡嗪酰胺抗结核治疗1年。结果随访8-12个月,平均10.3月,末次随访时疼痛视觉模拟评分（2.3±1.4）分,与术前（8.2±1.1）比较有显著性差异（配对t检验,t=25.23,P=0.00）。2例一侧大腿一过性前方麻木。植骨均获融合,融合时间6-12个月,平均9.2月。结论微创侧方入路病灶清除椎间融合术是治疗活动期腰椎结核有效和安全的方法。Objective To investigate the clinical effects of debridement,bone autograft and internal fixation via minimally invasive lateral approach for lumbar spine tuberculosis. Methods A retrospective analysis was made on the clinical data of 15patients（ 6 male cases and 9 female cases） with lumbar spine tuberculosis undergoing debridement,bone autograft and internal fixation via minimally invasive lateral approach from January 2013 to June 2014. The age ranged from 25 to 72 years old（ mean,48. 5 years old）. The involved vertebral bodies were at L2 /3in 6 patients,at L3 /4in 5 patients,and at L4 /5in 4 patients. All the cases received medication of four antitubercular drugs（ HRES） for 1 year after operation. Results All the patients were followed up for 8-12 months postoperatively（ mean,10. 3 months）. At the last follow-up review,the back pain VAS scores were improved from preoperative（ 8. 2 ± 1. 1） points to postoperative（ 2. 3 ± 1. 4） points（ paired t-test,t = 25. 23,P = 0. 00）. Two patients developed isolated,transient proximal lower extremity numbness. All the patients got solid bony union with an average fusion time of 9. 2 months（ range,6-12 months）. Conclusion Minimally invasive lateral approach debridement and interbody fusion is an effective and safe treatment for thoracic and lumbar spinal tuberculosis.

关 键 词：微创 脊柱结核 椎间融合术 

分 类 号：R687.3[医药卫生—骨科学]