Ⅰ期病灶清除植骨内固定治疗腰椎间盘炎19例临床分析

Radical debridement and interbody autografting with internal fixation for the treatment of lumbar spondylodiscitis

目的探讨Ⅰ期病灶清除植骨融合内固定治疗腰椎间盘炎的临床疗效及治疗方法。方法对1998年2月～2004年8月我院收治19例腰椎间盘炎患者的临床资料进行回顾性分析，其中7例原发性腰椎间盘炎Ⅰ期行前路病灶清除椎间植骨融合内固定术，12例腰椎间盘术后椎间盘炎行后路病灶清除、椎弓根螺钉系统内固定、脊柱融合术，观察手术治疗的临床疗效。结果患者术后剧烈腰痛即感明显缓解，不再需用止痛剂，能自行翻身，切口无感染，抗生素治疗6～8周。随访5～53个月，病变间隙术后3～6个月达到骨性融合，无腰痛后遗症。结论Ⅰ期病灶清除植骨内固定治疗腰椎间盘炎能迅速缓解症状，缩短病程和住院时间，利于脊柱融合，减少惠者的痛苦及经济负担，是治疗腰椎间盘炎的有效手段。

Objective To evaluate the clinical efficacy of radical debridement and spinal fusion with internal fixation in surgical management for the treatment of lumbar spondylodiscitis. Methods Nineteen cases of lumbar spondylodiscitis were analysed retrospectively. All patients were treated with surgical management of posterior or anterior approach combined with antibiotics. Results After the surgery, the symptoms were relieved in a short period of time. All patients had good results without associated complication. The incision were cured for the first term. No brace was needed. The roentgenographic followe-up showed the spinal fusion 3-6 months after surgery. Conclusion The results show that radical debridement and spinal fusion with internal fixation has more advantages over the conservative treatment in the treatment of the lumbar spondylodiscitis.