前路病灶清除钛笼植骨内固定治疗胸腰椎结核的效果研究  

Effect of Anterior Approach Lesion Clearance with Titanium Cage Bone Grafting and Internal Fixation in the Treatment of Thoraco-lumbar Spinal Tuberculosis

作　　者：夏云峰[1] XIA Yunfeng(Department of Orthopaedics,Jilin Provincial Tuberculosis Hospital,Changchun 130500,Jilin,China)

机构地区：[1]吉林省结核病医院骨科,吉林长春130500

出　　处：《世界复合医学（中英文）》2024年第7期59-62,共4页World Journal of Complex Medicine

摘　　要：目的分析前路病灶清除联合钛笼植骨内固定治疗胸腰椎结核(thoraco-lumbar spinal tu⁃berculosis,TLSTB)的效果。方法选取2021年9月—2023年8月吉林省结核病医院收治的90例TLSTB患者为研究对象,按照内植物的不同分为对照组与研究组,各45例。两组患者均采用小切口前路病灶清除术,对照组术中使用髂骨支撑植骨联合钢板内固定,研究组使用钛笼植骨联合钛板内固定。比较两组术中出血量、手术时间、住院时间、植骨融合时间、Cobb角、Oswestry功能障碍指数(Oswestry Dability Index,ODI)评分与并发症发生率。结果与对照组相比,研究组术中出血量更少,手术时间更短,差异有统计学意义(P均<0.05)。两组住院时间、植骨融合时间比较,差异无统计学意义(P均>0.05)。术后6个月研究组Cobb角为(4.78±0.75)°,ODI评分为(17.05±2.56)分,均低于对照组的(5.42±0.90)°、(20.12±2.74)分,差异有统计学意义(t=3.665、5.492,P均<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论TLSTB患者在前路病灶清除中使用钛笼植骨内固定治疗能够缩短手术操作时间,减少术中出血量,抑制Cobb角丢失,促进患者椎体功能恢复。Objective To analyze the effect of anterior approach lesion clearance combined with titanium cage bone grafting and internal fixation in the treatment of thoraco-lumbar spinal tuberculosis(TLSTB).Methods A total of 90 patients with TLSTB admitted to Jilin Provincial Tuberculosis Hospital from September 2021 to August 2023 were selected as the research objects.According to different implants,they were divided into control group and study group,with 45 cases in each group.The two groups of patients were treated with small incision anterior debridement.The control group was treated with iliac support bone graft combined with plate internal fixation,and the study group was treated with titanium cage bone grafting combined with titanium plate internal fixation.The intraoperative blood loss,operation time,hospitalization time,bone graft fusion time,Cobb angle,Oswestry Disability Index(ODI)and complication rate were compared between the two groups.Results Compared with the control group,the study group had less intraoperative blood loss and shorter operation time,and the differences were statistically significant(both P<0.05).There were no significant differences in hospitalization time and bone graft fusion time between the two groups(both P>0.05).At 6 months after operation,the Cobb angle of the study group was(4.78±0.75)°,and the ODI was(17.05±2.56)points,which were lower than those of the control group[(5.42±0.90)°,(20.12±2.74)points],and the differences were statistically significant(t=3.665,5.492,both P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Anterior lesion clearance with titanium cage bone grafting and internal fixation can effectively shorten the surgical time,reduce intraoperative bleeding,suppress Cobb angle loss,and promote vertebral function recovery in the treatment of TLSTB.

关 键 词：前路病灶清除 胸腰椎结核 钛笼植骨 内固定 

分 类 号：R4[医药卫生—临床医学]