一期后路手术治疗跳跃性胸腰椎布病脊柱炎  

One-stage posterior operation in treatment of skipped thoracolumbar brucellosis spondylitis

作　　者：张耀[1] 张强[1] 赵昌松[1] 陈佳敏 马睿 袁征[1] ZHANG Yao;ZHANG Qiang;ZHAO Chang-song;CHEN Jia-min;MA Rui;YUAN Zheng(Department of Orthopedics and Pathology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院骨科,北京100015

出　　处：《颈腰痛杂志》2024年第1期32-35,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：首都医科大学附属北京地坛医院院内科研基金“桥梁计划”项目(编号:DTQL201803)。

摘　　要：目的探讨一期后路手术治疗跳跃性胸腰椎布病脊柱炎的临床疗效。方法回顾性分析2016年9月~2019年10月收治的12例病灶呈跳跃性分布的胸腰椎布病脊柱炎患者。比较手术前后疼痛视觉模拟评分(visual analogue scale,VAS)、腰痛日本骨科协会评分(Japanese orthopedic association score,JOA)、Oswestry功能障碍指数(Oswestry disability index,ODI)、美国脊髓损伤协会(American spinal injury association,ASIA)分级及红细胞沉降率(erythrocyte sedimentation rate,ESR)、C-反应蛋白(C-reactive protein,CRP)。结果所有患者术后2周及术后1年,VAS、JOA、ODI与术前比较均有统计学差异(均为P<0.001);术后1年的VAS、JOA、ODI与术后2周比较,也均有统计学差异(均为P<0.001)。术后2周,所有患者ESR、CRP较术前均有所下降,但与术前比较均无统计学差异(P=0.430,P=0.395)。但术后1年的ESR、CRP与术前及术后2周比较,均有统计学差异(均为P<0.001)。9例脊髓或神经压迫症状患者的ASIA分级由术前B级1例、C级2例、D级6例,恢复至术后1年时D级1例、E级8例,具有统计学差异(P=0.011)。结论一期后路病灶清除、减压、内固定、椎间植骨融合手术治疗跳跃性胸腰椎布病脊柱炎,手术安全、可行。Objective To discuss the clinical effect of one-stage posterior approach on patients with skipped thoracolumbar brucellosis spondylitis.Methods From September 2016 to October 2019,the clinical data of 12 patients with skipped thoracolumbar brucellosis spondylitis were retrospectively analyzed.The visual analogue scales(VAS),the Japanese Orthopaedic Association Scores(JOA),the Oswestry disability index(ODI),the American spinal injury association(ASIA),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)are used for clinical efficacy evaluation.Results Two weeks after operation and one year after operation,VAS,JOA and ODI were significantly different from those before operation(all P<0.001).Moreover,VAS,JOA and ODI were statistically different at one year after operation compared with two weeks after operation(all P<0.001).Two weeks after operation,ESR and CRP decreased compared with those before operation,but there were no statistical differences compared with those before operation(P=0.430,P=0.395).However,one year after operation,ESR and CRP were statistically different from those before operation and two weeks after operation(all P<0.001).The ASIA classification of 9 patients with spinal cord or nerve compression symptoms before the operation was 1 case of grade B,2 cases of grade C,and 6 cases of grade D.One year after operation,there was 1 case of grade D and 8 cases of grade E.There was statistical difference(P=0.011).Conclusion The one-stage posterior approach for the treatment of skipped thoracolumbar brucellosis spondylitis is safe and feasible.

关 键 词：胸腰椎 布病脊柱炎 跳跃性 手术治疗 

分 类 号：R378.5[医药卫生—病原生物学]