后路病灶清除植骨融合内固定术在脊柱结核患者中的应用效果

The effect of posterior debridement and bone graft fusion with internal fixation in patients with spinal tuberculosis

目的探讨后路病灶清除植骨融合内固定术在脊柱结核患者中的应用效果。方法回顾性分析2009年1月至2014年1月来保定市第三中心医院就诊的脊柱结核患者共84例,所有患者均接受后路病灶清除植骨融合内固定术。记录治疗前、后患者神经功能ASIA分级、功能障碍指数(ODI)、疼痛视觉模拟评分(VAS)、后凸角、红细胞沉降率(ESR);同时记录患者在手术时的手术时间和术中出血量,对数据进行对比分析。结果手术后后凸角、ODI与术前相比明显改善,差异有统计学意义(P<0.05);手术后患者VAS评分为和ESR明显改善,差异有统计学意义(P<0.05);患者平均手术时间为(198.9±44.3)min,平均出血量(551.2±123.6)mL。术后随访发现无复发及感染发生,且无并发症发生。结论后路病灶清除植骨融合内固定术用以治疗脊柱结核患者具有良好的效果,且安全性较高。

Objective To discuss the effect of posterior debridement and bone graft fusion with internal fixation on spinal tuberculosis patients.Methods A total of 84 patients with spinal tuberculosis were retrospectively analyzed from January 2009 to January 2014.All patients were treated with posterior debridement and internal fixation.Before and after treatment,the nerve function ASIA classification,patients with disability index（ODI）and visual analogue scale（VAS）,cobb angle,erythrocyte sedimentation rate（ESR）were recorded;at the same time,the operation time and the amount of bleeding during the operation were recorded,and the data was analyzed.Results After surgery,cobb angle and ODI was significantly improved compared with preoperative（P〈0.05）;after surgery,the VAS score and ESR were significantly improved,the difference was statistically significant（P〈0.05）;the average operation time was（198.9±44.3）min,the average amount of bleeding was（551.2±123.6）mL.No recurrence and infection occurred,and no complication occurred.Conclusion Posterior debridement and bone graft fusion with internal fixation in treatment patients with spinal tuberculosis has good effect,and the safety is high.