一期后路微创内固定及前路病灶清除植骨治疗胸腰椎结核的随访研究

发布时间：2018-08-04 09:12

【摘要】：目的分析在治疗胸腰椎结核中,使用一期后路行微创椎弓根螺钉系统内固定及前路结核病灶清除植骨效果。方法对我院行一期后路微创内固定及前路病灶清除植骨治疗的26例胸腰椎结核中的24例患者进行2年后的跟踪随访,其中胸椎结核(T7~T10)6例,胸腰段结核(T11~L2)14例,腰椎结核(L3~L5)6例。测量Cobb角,进行ODI评分及VAS评分,比较远期疗效。结果所有患者均无结核复发,8例脊髓神经功能受损的患者随访中完全恢复至E级,随访时间为5-7年,平均6年,在最后一次随访中患者后凸Cobb角与术后2年无显著差异(P0.05),末次随访中所有随访患者ODI评分及VAS评分结果良好。结论使用一期后路行微创椎弓根螺钉系统内固定及前路结核病灶清除植骨治疗胸腰椎结核5年以上随访结果良好,提示该术式治疗胸腰椎结核效果肯定。
[Abstract]:Objective to analyze the effect of internal fixation of minimally invasive pedicle screw system and removal of bone graft by anterior approach in the treatment of thoracolumbar tuberculosis. Methods Twenty-four of 26 patients with thoracolumbar tuberculosis treated with one-stage posterior minimally invasive internal fixation and anterior debridement were followed up for 2 years, including 6 cases of thoracic spinal tuberculosis (T7~T10), 14 cases of thoracolumbar tuberculosis (T11~L2) and 6 cases of lumbar tuberculosis (L3~L5). Cobb angle, ODI score and VAS score were measured. Results all the patients had no recurrence of tuberculosis and 8 patients with spinal cord nerve function impairment recovered to grade E during follow-up. The follow-up time was 5 to 7 years, with an average of 6 years. There was no significant difference between the Cobb angle of kyphosis and 2 years after operation in the last follow-up (P0.05). The results of ODI and VAS scores were good in all the patients at the last follow-up. Conclusion the treatment of thoracolumbar tuberculosis by one stage posterior approach with minimally invasive pedicle screw system fixation and bone grafting with anterior approach is satisfactory, which suggests that this method is effective in the treatment of thoracolumbar tuberculosis.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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