【摘要】 目的:探讨Ⅰ期后路病灶清除椎间植骨融合内固定治疗原发性腰椎间盘炎的临床疗效。方法:回顾性分析2005年1月至2012年6月收治的原发性腰椎间盘炎13例,其中男9例,女4例;年龄31⁶8岁,平均56岁;L_3,4间隙2例,L_4,5间隙4例,L₅S₁间隙7例。伴有糖尿病2例,高血压4例,陈旧性肺结核1例。血沉（ESR）为12⁸9 mm/h,平均42 mm/h;C-反应蛋白8¹14 ng/L,平均47 ng/L。13例患者均无手术及穿刺病史,腰部剧烈疼痛,活动受限,保守治疗无效。术前视觉模拟评分（VAS）评分5¹0分,平均7.8分,行后路病灶清除椎间植骨融合内固定手术。结果:术后患者伤口愈合满意出院,持续有效抗生素静脉使用4周,口服抗生素2周。所有病例获得随访,时间7²4个月,平均18个月。VAS评分0¹分,无内固定断裂、复发患者,植骨均融合,术后病理检查均提示炎症性改变。结论 :Ⅰ期后路病灶清除椎间植骨融合内固定术治疗原发性腰椎间盘炎疗效确切,可较快缓解疼痛,早期活动。更多还原

【Abstract】 Objective:To evaluate the clinical effects of posterior debridement,interbody fusion with internal fixation in the treatment of lumbar discitis. Methods:The clinical data of 13 patients with lumbar discitis treated from January 2005 to June2012 was retrospectively analyzed. There were 9 males and 4 females,aged from 31 to 68 years old with an average of 56 years old.There were 2 cases on L_3,4,4 cases on L_4,5,and 7 cases on L₅S₁. Two cases complicated with diabetes,4 cases with hypertension,and 1 case with obsolete pulmonary tuberculosis. ESR level of 13 cases was 12-89 mm/h with an average of 42 mm/h;and C reactive protein fluctuations level was level 8-114 ng/L with an average of 47 ng/L. All the patients denied history of operation or injection,and the main symptom was severe pain and limitation of motion in lumbar,with no efficacy for conservative methods.Preoperative VAS was from 5 to 10 points with an average of 7.8 points. All patients were treated with posterior debridement,interbody fusion,and internal fixation. Results:All the patients left hospital after wound healing,and the effective antibiotics were continuously used for 4 weeks intravenously and 2 weeks for orally. All patients were followed up from 7 to 24 months with an average of 18 months. VAS decreased for 0-1 point. No internal fixation breakage,and recurrence were found. Bone graft got fusion,and postoperative pathology showed phlogistic changes. Conclusion:One-stage posterior debridement,interbody fusion with internal fixation was an effective method in treating lumbar discitis,and it lead to quicker relived pain relief and earlier mobilization.更多还原