【摘要】 目的探讨单纯前路与一期前后路病灶清除植骨内固定两种手术方式在治疗L5∕S1结核临床疗效。方法回顾性分析17例L5∕S1结核患者行手术治疗。男13例,女4例;年龄23~62岁,平均39岁。病程6~24个月。前路病灶清除植骨内固定术7例(A组),前路病灶彻底清除、植骨加后路器械固定、融合治疗腰骶段脊柱结核10例(B组),术后随访时间16~48个月,平均22个月,记录手术时间,术中出血量,住院时间,患者随访期间植骨融合时间,术前、术后及末次随访VAS评分和下腰痛JOA评分,比较组间差异。结果两组之间平均植骨融合时间,术前、术后及末次随访VAS评分和下腰痛JOA评分等指标无显著统计学意义(>0.05),手术时间,术中出血量及住院时间有统计学意义(<0.05)。两组所有患者均达到骨性融合,融合时间4~7个月,平均6个月。8例神经根受压症状术后消失。结论单纯前路与一期前后路病灶清除植骨内固定两种手术方式在治疗L5∕S1结核均达到满意疗效。单纯前路手术在手术时间、术中出血量及住院时间方面优于一期前后路手术。更多还原

【Abstract】 Objective To compare the efficacy of the anterior and antero-posterior approaches for treating L5∕S1vertebral tuberculosis. Methods Retrospective analysis of 17 patients with L5∕S1tuberculosis were performed. There were 13 males and 4 females, with an average age of 39 years(range, 23 to 62 years). The course of disease was 6 to 24 months.The anterior(A group, 7 cases)and antero-posterior(B group, 10 cases)approaches were treated on cases who were followed up for average of 22 months(range, 6 to 48 months). The average surgical time, blood loss, hospital stay,bony fusion time and pre-operative, post-operative and last follow-up of averaged visual analogue scale(VAS) and JOA scores were documented and compared between groups. Results There was not statistical significance in fusion time,averaged VAS and JOA scores of groups A and B( >0.05). The average surgical time, blood loss and hospital stay of the two groups was statistical significance( <0.05). Bony fusion was achieved in both groups, with an average fusion time of 6 months(range, 4 to 7 months). The radiculopathy in 8 cases recovered well. Conclusion Both the anterior and antero- posterior approaches can effectively heal L5∕S1vertebral tuberculosis, but the average surgical time, blood loss and hospital stay following the anterior approach are better than those following the antero-posterior approach.更多还原