一期经椎弓根截骨病灶清除人工椎体置入及置管冲洗引流术治疗胸腰椎化脓性骨髓炎疗效分析

发布时间：2019-08-10 11:13

【摘要】：[目的]通过病例回顾性分析研究,评价一期后路经椎弓根截骨病灶清除+n-HA/PA66复合生物材料人工椎体置入+置管冲洗引流术治疗胸腰椎化脓性骨髓炎的临床疗效。[方法]回顾性分析2012年10月~2015年8月本科收治并进行手术的胸腰椎化脓性骨髓炎(T_5~S_1)患者15例,平均年龄46.8岁。其中胸椎1例,胸腰段5例,腰椎8例,骶椎1例,对手术时间、术中出血量及手术前后Cobb角、VAS评分、CRP、ESR、融合时间等进行统计,评价手术治疗的效果及远期疗效。[结果]15例患者均得到随访,随访时间6~24个月,平均15个月,所有患者均无神经功能损伤等严重并发症。手术时间平均(183±12.5)min,术中出血量平均(1 050±80.5)ml;术前与术后3个月比较Cobb角无明显变化(P0.05),术前术后VAS评分、ESR等差异均有统计学意义(P0.05)。[结论]一期后路经椎弓根截骨病灶清除+n-HA/PA66复合生物材料人工椎体置入+置管冲洗引流治疗胸腰椎化脓性骨髓炎可以有效的清除病灶,感染复发率低,植骨融合率高,是一种安全、有效的方法。
[Abstract]:[objective] to evaluate the clinical effect of primary posterior pedicle osteotomy n-HA/PA66 composite biomaterial artificial vertebral body placement and drainage in the treatment of suppurative osteomyelitis of thoracolumbar vertebrae through retrospective analysis of cases. [methods] from October 2012 to August 2015, 15 patients with thoracolumbar suppurative osteomyelitis (T_5~S_1), with an average age of 46.8 years, were analyzed retrospectively. the patients were treated with suppurative osteomyelitis of thoracolumbar vertebrae from October 2012 to August 2015. There were 1 case of thoracolumbar vertebrae, 5 cases of thoracolumbar vertebrae, 8 cases of lumbar vertebrae and 1 case of sacral vertebrae. The operation time, intraoperative bleeding volume, Cobb angle before and after operation, VAS score and CRP,ESR, fusion time were counted to evaluate the effect and long-term effect of surgical treatment. [results] all the 15 patients were followed up for 6 to 24 months, with an average of 15 months. All patients had no serious complications such as neurological injury. The average operation time was (183 卤12.5) min,. The average intraoperative blood loss was (1050 卤80.5) ml;. There was no significant change in Cobb angle between before and 3 months after operation (P 0.05). There were significant differences in VAS score and ESR before and after operation (P 0.05). [conclusion] one stage posterior pedicle osteotomy n-HA/PA66 composite biomaterial artificial vertebral body placement irrigation and drainage can effectively clear the focus, the recurrence rate of infection is low, and the fusion rate of bone graft is high, which is a safe and effective method for the treatment of suppurative osteomyelitis of thoracolumbar vertebrae.
【作者单位】：湖南省常德市第一人民医院脊柱外科;
【分类号】：R687.31

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