一期前路病灶清除植骨内固定术治疗颈椎布鲁杆菌性脊柱炎

发布时间：2018-05-11 04:13

本文选题：布鲁杆菌性脊柱炎 + 颈椎　；参考：《中国矫形外科杂志》2015年01期

【摘要】：[目的]探讨颈椎布鲁杆菌性脊柱炎有效的外科治疗方法及临床效果。[方法]对2002年1月~2012年1月期间,经临床及实验室检查确诊且具有手术指征的颈椎布鲁杆菌性脊柱炎的患者32例采用一期前路病灶清除植骨内固定术治疗。男21例,女11例;年龄40~69岁,平均49.5岁。病程3~6个月,平均4.5个月。2个椎体受累24例,3个椎体受累8例。均合并不同程度神经功能损伤。术后末次随访行疼痛视觉模拟评分(VAS)、日本骨科协会评分(JOA)、临床疗效评价以及X线片、MRI影像学观察。[结果]术后32例均获随访,随访时间24~48个月,平均32个月。术后椎体间植骨融合,无断钉、断板、复发病例。术前及末次VAS评分为(9.0±0.6)、(1.0±0.7),JOA评分为(8.0±1.6)、(14.9±1.7),术后VAS评分和JOA评分均较术前显著改善,差异有统计学意义(P0.05)。临床疗效评价:术后均无加重患者,末次随访优良率为100%。末次随访复查X线片及MRI未发现复发。[结论]一期前路病灶清除植骨内固定术治疗颈椎布鲁杆菌性脊柱炎,可以控制病变部位发展,缓解疼痛,重建颈椎稳定性,恢复神经功能,临床效果满意。
[Abstract]:[Objective] to explore the effective surgical treatment and clinical effect of brucellosis spondylitis. [Methods] 32 patients with brucellosis spondylitis diagnosed by clinical and laboratory examination in January ~2012 January 2002 were treated with one phase anterior debridement and internal fixation for the treatment of brucellosis spondylitis. 21 males and 11 females. An average age of 49.5 years old. The average age of 49.5 years was 49.5 years. The course of disease was 3~6 months, 24 cases were involved in the average 4.5 months of.2 vertebral involvement, and 8 cases were involved in 3 vertebral bodies. The pain visual analogue score (VAS), the Japanese Department of orthopedics Association score (JOA), the clinical efficacy evaluation, and the X-ray film, and the MRI imaging observation. [results] 32 cases were observed. The follow-up time was 24~48 months, an average of 32 months, with an average of 32 months. After the operation, bone fusion, no nail breaking, broken plate, and recurrent cases. The preoperative and final VAS scores were (9 + 0.6), (1 + 0.7), JOA score was (8 + 1.6) and (14.9 + 1.7). The postoperative VAS score and JOA score were significantly improved (P0.05). The difference was statistically significant (P0.05). The clinical effect evaluation was: None of the patients were aggravated after the operation. The excellent rate of the last follow-up was 100%. final follow-up X-ray examination and MRI no recurrence. [Conclusion] the anterior debridement and internal fixation for the treatment of brucellosis spondylitis of cervical vertebra can control the development of the lesion, relieve the pain, reconstruct the cervical spine stability, restore the nerve function, and the clinical effect is satisfactory.

【作者单位】：河北北方学院研究生院外科;河北北方学院附属第一医院骨科;
【基金】：2013年河北省医学重点学科跟踪项目(编号:GL201321) 2013年河北省省级重大医学科研课题(编号:zd2013049) 张家口市2010年科学技术与发展指令计划资助项目(编号:1012010D-1)
【分类号】：R516.7

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