单节段脊柱结核椎间颗粒植骨与髂骨块植骨融合术的对比分析

发布时间：2018-03-23 07:32

本文选题：单节段脊柱结核　切入点：椎间融合术　出处：《实用医学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的对比后路椎间自体颗粒植骨与自体髂骨块植骨两种融合术治疗单节段脊柱结核的融合效果。方法本院2010年1月至2015年6月应用颗粒植骨与髂骨块植骨两种融合方式治疗单节段脊柱结核患者35例,均采用后路病灶清除,植骨融合,其中颗粒植骨16例,髂骨块植骨19例,按JOA、VAS评分、手术时间、术中失血量、手术前后后凸畸形Cobb角、融合时间对其融合效果进行对比分析。结果所有患者均获随访,随访时间12~24个月,平均18.5个月,椎间植骨均融合良好,未发现螺钉失效及植骨块脱入椎管。(1)两组术后JOA评分、VAS评分比较,差异无统计学意义;(2)手术时间及术中失血量颗粒植骨少于髂骨块植骨,组间差异有统计学意义;(3)两组术后矫正后凸畸形角度上差异无统计学意义,但术后各时段对比Cobb角度丢失,颗粒植骨组大于髂骨块植骨,差异有统计学意义;(4)两组间融合时间比较,差异无统计学意义。结论两种融合方式在临床症状缓解程度、融合时间上比较,差异无显著性。颗粒植骨在手术时间、出血量等方面优于髂骨块组,但颗粒植骨随访中更容易丢失Coob角度,两种植骨方式在单节段脊柱结核手术中均是有效的植骨方式,除严重脊柱失稳、年龄较大,骨质疏松患者外均可采取颗粒植骨。
[Abstract]:Objective to compare the fusion effect of posterior intervertebral autografted bone graft and autogenous iliac bone graft in the treatment of single segmental spinal tuberculosis. Methods from January 2010 to June 2015, two kinds of fusion methods granulated bone grafts and iliac bone grafts were used in our hospital. 35 cases of single segment spinal tuberculosis were treated with combined treatment. All patients were treated with posterior debridement, bone graft fusion, including 16 cases of granular bone graft and 19 cases of iliac bone graft. According to JOAA VAS score, operative time, blood loss during operation, Cobb angle of kyphosis deformity before and after operation. Results all the patients were followed up for 12 ~ 24 months (mean 18.5 months). There was no significant difference in JOA score and VAS score between the two groups (P < 0.05). The time of operation and the amount of blood loss during operation were less than those of iliac bone graft. There was no significant difference in the angle of correction of kyphosis between the two groups, but the loss of Cobb angle was higher in the granular bone graft group than in the iliac bone graft group. There was no significant difference in fusion time between the two groups. Conclusion there was no significant difference between the two fusion methods in clinical symptom relief and fusion time. The amount of bleeding was better than that of iliac bone graft group, but the Coob angle was more easily lost in the follow-up of bone grafts. The two methods of bone grafting were effective in the operation of single segment spinal tuberculosis, except for the severe spinal instability, the age was older. Patients with osteoporosis can be treated with bone grafts.
【作者单位】：青海省人民医院脊柱外科;
【分类号】：R687.3

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