前后路联合一期手术治疗腰骶椎结核临床疗效研究  

Clinical study of anterior and posterior joint surgery for lumbosacral vertebral tuberculosis

作　　者：赵涛 方海林 王志远 彭茂轩 高腾飞 姚林明 Zhao Tao;Fang Hailin;Wang Zhiyuan(Shaanxi Province Tuberculosis Prevention and Treatment Institute,Xi＇an 710100)

机构地区：[1]陕西省结核病防治院,西安710100 [2]西安市红会医院,西安710054

出　　处：《陕西医学杂志》2018年第11期1448-1450,共3页Shaanxi Medical Journal

摘　　要：目的:探讨前后路联合一期手术治疗腰骶椎结核的临床疗效。方法:腰骶段脊柱结核患者32例均行一期后路内固定,前路病灶清除术治疗,其中20例前路病灶清除同时植骨融合术。术后抗结核治疗18个月。结果:32例患者前后路手术时间170～250min,平均时间220min,术中出血700～1300ml,平均出血1000ml,住院时间35～62d,平均41d;术后随访12～24个月,平均18个月,结核无复发,腰背部疼痛、下肢放射痛麻木症状完全恢复,所有植骨均获骨性融合,无内固定松动断裂现象。结论:前后路联合手术治疗腰骶椎结核有利于恢复脊柱稳定性提高腰骶椎结核治愈率。ObjectiveTo study the clinical efficacy of anterior and posterior approach combined with one-stage operation for lumbar vertebral tuberculosis.Methods： From May 2010 to August 2015, 32 patients with lumbosacral spinal tuberculosis were treated in our hospital. Thirty-two patients underwent posterior internal fixation at one time, 20 patients underwent anterior focus debridement and fusion, and 12 patients underwent anterior focus debridement without bone grafting. Anti-tuberculous treatment was performed for 18 months after surgery. we compared the symptoms of low back pain and radiating pain in the lower extremities between the preoperative and the postoperative. Results： The operation time of the 32 patients ranged from 170 minutes to 250 minutes. The average time of the operation was 220 minutes. The intraoperative blood loss was 700-1300 ml and the mean bleeding was 1000 ml. Hospital stay 35~62 days, an average of 41 days,The follow-up period was 12~24 months, with an average of 18 months. There were no recurrence of tuberculosis and the symptoms of back pain, lower limb radiation pain and numbness were completely recovered, all bone grafts were bony fusion, no internal fixation loose fracture phenomenon.Conclusion： Anterior and posterior surgery combined with lumbosacral vertebral tuberculosis is beneficial to restore spinal stability and improve fusion rate.

关 键 词：结核 脊柱/外科学 固定 前后路联合 

分 类 号：R659[医药卫生—外科学]