腰椎术后椎间隙感染的后路手术治疗探讨

A discussion on the treatment of postoperative lumbar intervertebral disctis by the posterior debridgement

目的探讨经腰椎后路病灶清除、减压、引流手术治疗腰椎术后椎间隙感染的疗效。方法回顾腰椎术后椎间感染的 38例患者 ,分析其临床表现 ,实验室检查及诊断要点 ,其中保守治疗12例 ,后路手术治疗 2 6例。结果保守治疗患者 ,使用抗菌素平均 4 7 7天 ,绝对卧床制动平均 12 3 1天 ,腰痛症状逐渐减轻 ,需住院治疗平均 80 4天 ,X片显示椎间隙融合时间平均 2 5 8 7天。 2 6例经后路手术治疗患者 ,使用抗菌素平均 16 3天 ,卧床平均 4 8 2天 ,住院时间平均 2 8 9天 ,X片显示椎间隙融合时间平均 171 5天 ,术后 5～ 10天症状明显缓解。两种治疗方法经统计学比较 ,P <0 0 5 ,差异有显著意义。结论经腰椎后路病灶清除、减压、引流手术能迅速缓解和解除病人症状 ,手术简便有效 ,缩短病程 ,减少住院时间 ,值得推广应用。

Objective To evaluate the therapeutic effect of the treatment of postoperative lumbar intervertebral disctis, including focal cleaning, decompression and irratation. Methods A retrospective of 38 cases was analyzed including symptom, laboratory examination and diagnosis. 12 cases were treated by conservative method, while the other 26 cases were treated surgically by the posterior debridgement. Results The symptom of the 12 cases was alleviated slowly, using antibiotic average 47.7 days, keeping in the bed 123.1 days and staying in hospital 80.4 days. The average time of intervertebral fusion on radiography imagine was 258.7 days. 26 cases underwent the surgical treatment had remarkable improvement of symptom only 5-10 days after surgery. The counterpart parameters were 16.3 days, 48.2 days, 28.9 days and 171.5 days respectively. Significant difference existed between the two methods (P<0.05). Conclusion The operation is easy and can reduce the time of staying in hospital. It is worth being popularized to treat intervertebral disctis.