手术治疗腰椎布鲁杆菌病性脊椎炎17例临床分析

Surgical treatment of lumbar Brucellar spondylitis in 17 cases

目的探讨腰椎后路入路一期病灶清除植骨内固定治疗腰椎布鲁杆菌病性脊椎炎的手术效果。方法17例布鲁杆菌病性脊椎炎患者，腰椎后路入路行一期病灶清除减压、植骨内固定术治疗。结果17例手术均顺利，手术时间120～180min，术中出血量400600mL；术后无脊髓及神经根损伤发生，患者症状均改善；随访3～18个月，随访期无复发、无断钉及内固定失效，椎间植骨均获骨性融合，融合时间为9～12个月；至末次随访时，Hirabayashi恢复率评定优6例，良6例，中2例，差1例，治疗优良率80％。结论经腰椎后路入路一期病灶清除植骨内固定手术治疗腰椎布鲁杆菌病性脊椎炎疗效确切、安全。

Objective To evaluate the surgical outcome of posterior loci debridement and antograft with internal fixation for lumbar Brucellar spondylitis. Methods Seventeen patients with lumbar Brucellar spondylitis underwent posterior foci debridement and autograft with internal fixation. Results The operation was performed smoothly in all patients and lasted for 120 to 180 rain. The intraoperative blood loss was 400 to 600 mL, with no spinal cord injury or nerve root injury. All symptoms were relieved. The follow-up for 3 to 18 months showed no recurrence, no broken nails and no fixation failure. The last follow-up result showed Hirabayashi recovery rate assessment was excellent in 6 cases, good in 6 cases, medium in 2 cases, and poor in 1 case. The excellent rate was 80%. All achieved bony fusion in 9 to 12 months. Conclusion The method of posterior foci debridement and antograft with internal fixation is effective and safe for lumbar Brucellar spondylitis.