【摘要】 目的探讨一期后路经皮椎弓根螺钉固定联合侧前方入路病灶清除植骨融合术治疗腰椎结核的临床疗效。方法选择87例腰椎结核行手术治疗的患者,分别采用一期前后联合入路手术(A组)和单纯侧前方入路手术(B组)。统计手术前后C反应蛋白(CRP)、红细胞沉降率(ESR)、局部前凸角(Cobb角)、ODI评分、Frankel评分及手术情况。结果 A组较B组手术时间长、术中出血多(P<0.05),但两组患者平均住院时间比较差异无统计学意义(P>0.05)。术后平均随访(20.30±3.70)个月,两组患者术后及末次随访时ESR、CRP、ODI评分、Frankel分级及Cobb角均较术前得到明显改善(P<0.05);A组患者植骨愈合时间明显短于B组(P<0.05)。结论后路固定联合前路病灶清除手术治疗腰椎结核具有创伤小、脊柱稳定性良好、骨性愈合率高等优点。更多还原

【Abstract】 Objective To investigate the clinical efficacy of one-stage posterior percutaneous transpedicular screw fixation combined with lateral anterior approach for focus debridement bone graft fusion in the treatment of lumbar tuberculosis(TB).Methods Eighty-seven cases of lumbar tuberculosis treated by operation respectively adopted the one-stage anterior and posterior combined approach operation(group A)and simple lateral anterior approach operation(group B).The levels of CRP and ESR,Cobb angle,ODI score and Frankl score before and after surgery were statistically analyzed,and operation situation was analyzed in the two groups.Results The operation time and intraoperative bleeding volume in the group A were significantly more than those in the group B(P<0.05),but there was no statistically significant difference in average hospitalization time between the two groups(P>0.05).All cases were postoperatirely followed up for average(20.30±3.70)months.The levels of ESR and CRP,ODI score,Frankel score and Cobb angle after operation and at last follow up in the two group were significantly improved compared with before operation(P<0.05).The bone graft healing time in the group A was significanlly shester than that in the group B.Conclusion Posterior approach fixation combined with anterior approach debridement operation has the advantages of less trauma,fixation stability and high bone healing rate for treating lumbar tuberculosis.更多还原