前路病灶清除自体髂骨植骨融合内固定术治疗下颈椎结核伴后凸畸形的效果  

Effect of anterior debridement, autogenous iliac bone graft fusion and internal fixation in the treatment of lower cervical vertebrae tuberculosis with kyphosis deformity

作　　者：杨阳 古雨浓 葛朝元 杨文龙[3] 钱立雄 曹宏强 YANG Yang;GU Yunong;GE Chaoyuan;YANG Wenlong;QIAN Lixiong;CAO Hongqiang(Orthopedics Department,the People's Hospital of Huayin,Weinan 714200;No.2 Surgery Department,Shaanxi Armed Police Corps Hospital,Xi'an 710000;Spinal Surgery Department,Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054;Orthopaedics Department,the People's Hospital of Yanchang County,Yan'an 717199,China)

机构地区：[1]华阴市人民医院骨科,陕西渭南714200 [2]武警陕西省总队医院外二科,陕西西安710000 [3]西安交通大学附属红会医院脊柱外科,陕西西安710054 [4]陕西省延长县人民医院骨科,陕西延安717199

出　　处：《临床医学研究与实践》2024年第32期79-82,共4页Clinical Research and Practice

摘　　要：目的探讨前路病灶清除自体髂骨植骨融合内固定术治疗下颈椎结核伴后凸畸形的效果。方法选取接受前路病灶清除自体髂骨植骨融合内固定术治疗的40例下颈椎结核伴后凸畸形患者。记录手术情况;比较不同时间的红细胞沉降率(ESR)及C-反应蛋白(CRP)、视觉模拟量表(VAS)评分、日本骨科协会(JOA)评分及局部后凸Cobb角;记录末次随访的神经功能及复发情况。结果40例患者均顺利完成手术并获得完整随访,平均手术时间(120.8±12.5)min,平均术中出血量(90.6±12.2)mL,平均随访时间(37.8±8.6)个月。末次随访,患者的ESR、CRP、VAS评分、JOA评分及局部后凸Cobb角均优于术前、术后6个月(P<0.05)。末次随访,合并神经功能障碍患者的病情均有不同程度改善,且无结核复发。结论前路病灶清除自体髂骨植骨融合内固定术治疗下颈椎结核伴后凸畸形可有效清除结核病灶,改善患者颈部疼痛程度和后凸畸形,缓解机体功能障碍,促进神经功能恢复。Objective To investigate the effect of anterior debridement,autogenous iliac bone graft fusion and internal fixation in the treatment of lower cervical vertebrae tuberculosis with kyphosis deformity.Methods A total of 40 patients with lower cervical vertebrae tuberculosis with kyphosis deformity who underwent anterior debridement,autogenous iliac bone graft fusion and internal fixation were selected.The operation condition was recorded;the erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),Visual Analogue Scale(VAS)score,Japanese Orthopaedic Association(JOA)score and local kyphosis Cobb angle at different time were compared;the neurological function and recurrence at the last follow-up were recorded.Results All 40 patients successfully completed the surgery and received complete follow-up.The average operation time was(120.8±12.5)min,the average intraoperative blood loss was(90.6±12.2)mL,and the average follow-up time was(37.8±8.6)months.At the last follow-up,ESR,CRP,VAS score,JOA score and local kyphosis Cobb angle were better than those before operation and 6 months after operation(P<0.05).At the last follow-up,the state of patients with neurological dysfunction improved to varying degrees,and there was no recurrence of tuberculosis.Conclusion Anterior debridement,autologous iliac bone graft fusion and internal fixation for the treatment of lower cervical vertebrae tuberculosis with kyphosis deformity can effectively remove tuberculosis lesions,improve the degree of neck pain and kyphosis deformity,relieve body dysfunction,and promote neurological function recovery.

关 键 词：前路 内固定 下颈椎 结核 自体髂骨植骨 

分 类 号：R681.5[医药卫生—骨科学]