ILIF与TLIF治疗腰椎结核和布鲁杆菌病性脊柱炎的疗效比较  

Outcomes of ILIF and TLIF for treating lumbar spinal tuberculosis and brucellar spondylitis

作　　者：崔旭[1] 马远征[1] 陈兴[1] 罗展鹏[1] 李力韬[1] 罗小波[1] 

机构地区：[1]解放军第309医院全军骨科中心脊柱外科,北京100091

出　　处：《中国骨与关节损伤杂志》2015年第9期934-937,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较横突间入路腰椎椎体间融合术(ILIF)与经椎间孔腰椎体间融合术(TLIF)行病灶清除、椎间融合内固定术治疗腰椎结核和布鲁杆菌病性脊柱炎的疗效。方法自2010-08—2013-08共采用ILIF治疗腰椎结核和布鲁杆菌病性脊柱炎38例,与之前采用TLIF手术治疗此类患者39例进行比较,分析2种术式在手术时间,术中出血量,疼痛视觉模拟VAS评分,Oswestry功能障碍指数(ODI)和术后并发症的差异。结果 2组手术时间、术中出血量比较差异无统计学意义(P>0.05),术后VAS、ODI评分比较差异有统计学意义(P<0.01)。结论 ILIF治疗腰椎结核和布鲁杆菌病性脊柱炎的适应证较TLIF有限,仅适合于腰痛为主、无根性和马尾神经压迫症状、病变局限于椎间隙和相邻椎体终板者。其优点是可保留椎管的结构和生物力学完整性,避免病灶与椎管相通,损伤小、术后恢复快。Objective To compare outcomes of radical debridement and interbody fusion and internal fixation by ILIF and TLIF in treatment of lumbar spinal tuberculosis and brucellar spondylitis. Methods Between August 2010 and August 2013,38 patients with lumbar spinal tuberculosis and brucellar spondylitis were treated with ILIF. Thirty four patients were followed up for at least 2 years. Before this, 39 patients with same diseases had been treated with TILF and 31 patients were followed up for at least 2 years. Two kinds of operative methods were analyzed in operation time, intraoperative blood loss, visual analog pain VAS score, Oswestry disability index（ODI） and postoperative complications. Results The differences of the mean operation time and the average blood loss between the two groups were not statistically significant（P〉0.05）. The differences of postoperative VAS and ODI scores between the two groups were statistically significant（P〈0.01）. Conclusion The indications of ILIF in the treatment of lumbar spinal tuberculosis and brucellar spondylitis are less than those of TLIF. ILIF is indicated in patients with low back pain and without compression symptom of nerve root and coccygeal nerve, whose lesion locates in intervertebral space and endplates of adjacent vertebral bodies. The advantages of ILIF are that the integrity of structure and biomechanics of the spinal canal could be retained, as well as avoiding communication of the lesion and spinal canal. The trauma of ILIF is little and the recovery after operation is rapid.

关 键 词：腰椎结核 布鲁杆菌病 脊柱融合术 外科手术 

分 类 号：R687.3[医药卫生—骨科学]