单纯后路钉棒内固定治疗早中期胸腰椎结核的疗效

发布时间：2018-03-03 00:15

本文选题：后路钉棒内固定　切入点：胸腰椎结核　出处：《安徽医学》2016年11期 　论文类型：期刊论文

【摘要】：目的探讨单纯后路钉棒内固定治疗早中期胸腰椎结核的疗效。方法回顾性分析2008年10月至2014年10月安徽医科大学第二附属医院收治的35例胸腰椎结核患者的临床资料,根据手术不同术式分为A组前路植骨融合内固定组(20例)和B组后路钉棒内固定组(15例),分析两组手术时间、出血量、住院天数、术前术后及末次随访时的后凸角(Cobb角)、疼痛视觉评分(VAS评分)、Oswestry功能障碍问卷表(ODI评分)及神经功能恢复情况(Frankel分级)。35例患者均获随访。结果随访12~24个月,平均18个月。B组在手术时间、出血量及住院天数方面均低于A组,差异有统计学意义(P0.05)。A组Cobb角术后为(8.47±1.67)°较术前(13.28±3.12)°减小,VAS评分术后为(2.30±1.10)分较术前(7.10±1.20)分改善,ODI评分术后(13.70±3.50)分较术前(43.80±5.50)分改善,差异有统计学意义(P0.05)。B组Cobb角术后(5.37±2.21)°较术前(13.83±4.54)°减小,VAS评分术后(1.90±1.20)分较术前(7.10±1.10)分减少,ODI评分术后(13.90±3.10)分较术前(41.10±5.30)分减少,差异有统计学意义(P0.05)。两组组间手术前的Cobb角、手术前后VAS评分及ODI评分差异无统计学意义(P0.05)。B组在Cobb角矫正及防止丢失上优于A组,差异有统计学意义(P0.05)。根据Frankel分级,A组术前D级7例,E级13例,术后D级3例,E级17例,术前B组D级5例,E级10例,术后E级15例,两组差异无统计学意义(P0.05)。结论单纯后路钉棒内固定,不做病灶清除,其疗效优于植骨融合内固定,是治疗早中期脊柱结核的有效方法之一。
[Abstract]:Objective to evaluate the efficacy of posterior screw rod fixation in the treatment of thoracolumbar tuberculosis in early and middle stage. Methods from October 2008 to October 2014, 35 patients with thoracolumbar tuberculosis treated in the second affiliated Hospital of Anhui Medical University were retrospectively analyzed. According to the different operation methods, the patients were divided into two groups: group A (20 cases) and group B (15 cases). The operation time, blood loss and hospital stay were analyzed. All the patients were followed up before and after operation and at the last follow-up. All the patients were followed up for 12 ~ 24 months. The visual score of pain and the VAS score and the Oswestry dysfunction scale (Oswestry dysfunction questionnaire) and the recovery of nerve function were all followed up in 35 patients with Frankel grade. The mean operation time, bleeding volume and hospital stay in group B were lower than those in group A. The difference was statistically significant (P 0.05 卤1.20): the Cobb angle after operation was 8.47 卤1.67 掳lower than that before operation (13.28 卤3.12) 掳. The score was 2.30 卤1.10) after operation, and the score was improved by 13.70 卤3.50% than that of 43.80 卤5.50% before operation, compared with the preoperative score of 7.10 卤1.20 (P 0.05 卤1.20). The difference was statistically significant (P 0.05 卤2.21 掳vs 13.83 卤4.54 掳, P 0.05 卤2.21 掳, P 0.05 卤4.54 掳, P 0.05 卤4.54 掳, P < 0.05). The Cobb angle before operation was significantly lower in group B than that in group B (P < 0.05), and the score was lower than that in group B (P < 0.05), and the score of Cobb before operation was significantly lower than that in group B (P < 0.05), and the score of Cobb before operation was significantly lower than that in group B (P < 0.05). There was no significant difference in VAS score and ODI score before and after operation. Group B was superior to group A in Cobb angle correction and loss prevention, and the difference was statistically significant (P 0.05). According to Frankel classification, there were 7 cases of grade D and 17 cases of grade E before operation in group A, and 17 cases in group D after operation. In group B, there were 5 cases of grade D and 15 cases of grade E before operation. There was no significant difference between the two groups (P 0.05). Conclusion the curative effect of simple posterior screw rod fixation without debridement is better than that of bone graft fusion internal fixation. It is one of the effective methods for the treatment of spinal tuberculosis in early and middle stage.
【作者单位】：安徽医科大学第二附属医院骨科;
【分类号】：R687.3

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