后路经皮内固定加前路斜外侧椎间融合通道病灶清除植骨治疗腰椎结核  

Posterior percutaneous internal fixation plus anterior oblique lateral interbody fusion channel lesion debridement for treatment of lumbar tuberculosis

作　　者：张瑞[1] 李晓祥 刘涛[1] 任星光 钱澍 孙嗣国 钱济先[1] 廖博 ZHANG Rui;LI Xiao-xiang;LIU Tao;REN Xing-guang;QIAN Shu;SUN Si-guo;QIAN Ji-xian;LIAO Bo(Dept of Orthopaedics,the Second Affiliated Hospital of the Fourth Military Medical University of CPLA,Xi′an,Shaanxi 710038,China)

机构地区：[1]中国人民解放军第四军医大学第二附属医院骨科,陕西西安710038

出　　处：《临床骨科杂志》2021年第4期502-506,共5页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金面上项目(编号:81372045)。

摘　　要：目的探讨后路经皮内固定加前路斜外侧椎间融合(OLIF)通道病灶清除植骨治疗腰椎结核的疗效。方法采用后路经皮椎弓根螺钉内固定加前路OLIF通道病灶清除植骨治疗55例腰椎结核患者。记录围手术期指标,评估植骨融合情况。结果患者均获得随访,时间24~60个月。术中出血量360~695 ml,手术时间251~394 min,住院时间8~13 d。末次随访时,红细胞沉降率、C-反应蛋白、疼痛VAS评分、ODI、Cobb角较术前均明显改善(P <0.01);54例椎间植骨融合,1例未融合。结论后路经皮内固定加前路OLIF通道病灶清除植骨融合治疗腰椎结核,创伤小、康复快,能彻底清除病灶,恢复脊柱正常序列和稳定性。Objective To investigate the efficacy of posterior percutaneous internal fixation combined with oblique lateral interbody fusion( OLIF) channel lesion debridement for treatment of lumbar tuberculosis. Methods The 55 patients with lumbar tuberculoses were treated by posterior percutaneous pedicle screw internal fixation combined with anterior OLIF channel lesion debridement and bone grafting fusion. Perioperative indicators were recorded,and the situation of bone grafting fusion was evaluated. Results All patients were followed up for 24 ~ 60 months. The intraoperative blood loss was 360 ~ 695 ml,operation time was 251 ~ 394 min,the length of hospital stay was 8 ~ 13 d. At the last follow-up,the ESR,CRP,pain VAS,ODI and Cobb angle were significantly improved,compared with those before surgery( P < 0. 01). The 54 patients got intervertebral bone grafting fusion,and 1 case was non-fusion. Conclusions In the treatment of lumbar tuberculosis,the posterior percutaneous internal fixation combined with anterior OLIF channel lesion debridement and bone grafting are less trauma,faster recovery,which can completely remove the lesions,and restorate the normal sequence and stability of the spine.

关 键 词：腰椎结核 后路经皮固定 前路病灶清除 斜外侧椎间融合 

分 类 号：R592.2[医药卫生—老年医学] R687.3[医药卫生—内科学]