一期后路病灶清除、植骨融合内固定治疗胸腰段脊柱结核的临床研究

Clinical Study on Treatment of Thoracolumbar Spinal Tuberculosis with Primary Posterior Lesion Removal\Bone Graft Fusion and Internal Fixation

目的观察一期后路病灶清除、植骨融合内固定治疗胸腰段脊柱结核的临床效果。方法选取2017年2月至2018年1月黑龙江省传染病防治院收治的40例胸腰段脊柱结核患者,采取一期后路病灶清除、植骨融合内固定发进行治疗,并对患者治疗前后的各项数据进行比较研究。结果患者接受手术的时间为(225.31±4.57)min、手术中出血量为(508.24±22.14)mL。手术后3个月患者的脊柱后凸角、VAS评分以及ESR均明显优于手术前各项数据,两组比较数据有统计学意义(P<0.05)。患者术后1年,均为骨性融合,无患者出现吸收、骨块脱出等情况。结论对胸腰段脊柱结核患者采取一期后路病灶清除、植骨融合内固定法进行治疗,可有效的改善患者的脊柱后凸角情况、疼痛情况以及血沉情况,且手术患者中对患者的伤害较小。

Objective To observe the clinical effect of primary posterior approach lesion removal,bone graft fusion and internal fixation in the treatment of thoracolumbar spinal tuberculosis.Methods Forty patients with thoracolumbar spinal tuberculosis admitted to our hospital from February 2017 to January 2018 were selected.The patients were treated with stage 1 posterior lesion removal,bone graft fusion and internal fixation,and the data of the patients before and after treatment were compared.Results The operative time was 225.31±4.57 min and the intraoperative blood loss was 508.24±22.14 mL.In addition,the kyphus angle,VAS score and ESR at 3 months after surgery were significantly better than the data before surgery,with statistical significance(P<0.05).One year after the operation,all the patients had bone fusion,and none of them had bone resorption or bone mass prolapse.Conclusion The treatment of thoracolumbar spinal tuberculosis patients with stage 1 posterior lesion removal and bone graft fusion internal fixation can effectively improve the kyphosis angle,pain and ESR of the patients,with small injury to the patients.