摘要
背景:布鲁杆菌性脊柱炎单纯病灶清除植骨融合术后卧床时间长,患者起床活动后容易诱发脊柱不稳,植骨不愈合率较高,疗效不佳。目的:探讨采用病灶清除椎间植骨融合内固定修复腰椎布鲁杆菌病脊柱炎、稳定脊柱结构的疗效。方法:2007年1月至2013年8月新疆医科大学附属中医医院收治腰椎布鲁杆菌病性脊椎炎患者31例,男22例,女9例;年龄42-73岁,平均52岁;病程3-13个月,平均5个月。所有患者在利福平和米诺环素及链霉素联合药物治疗的基础上,采取一期病灶清除植骨融合,脊柱钉棒系统内固定。比较患者手术前后JOA评分评价预后及功能恢复情况,随访X射线片观察植骨融合情况。结果与结论:所有患者均获6-24个月的随访,平均随访12.6个月。患者修复后JOA评分较治疗前提高,差异有显著性意义(P<0.05);随访期间无复发及严重并发症发生;修复后5 d内复查X射线片,见所有患者植骨及内固定位置良好,末次随访X射线片显示植骨愈合良好,脊柱稳定。提示腰椎布氏菌杆性脊柱炎在三联药物治疗的同时,行病灶清除椎间植骨融合内固定治疗,能维持脊柱稳定性、减少并发症,可取得可靠的修复效果。
BACKGROUND：After simple debridement and fusion of brucel a spondylitis, bed time is long. Activities are likely to cause spinal instability. Bone nonunion rate is very high, and the curative effects are poor.
OBJECTIVE：To investigate the efficacy of debridement and interbody fusion fixation for repair of lumbar brucel ar spondylitis and for stable spine structure.
METHODS：A total of 31 cases of lumbar brucel ar spondylitis were obtained from Affiliated Hospital of Chinese Medicine, Xinjiang Medical University between January 2007 to August 2013, including 22 males and 9 females, at the age of 42-73 years, averagely 52 years. Their course of disease was 3-13 months, averagely 5 months. Al patients were administered combination therapy of rifampin and minocycline and streptomycin, and then received one-stage debridement and fusion, spinal pedicle screw fixation system. Japanese Orthopaedic Association scores were compared before and after the surgery for assessing prognosis and functional recovery. Bone fusion was observed using X-ray during fol ow-up.
RESULTS AND CONCLUSION：Al patients were fol owed up for 6-24 months, averagely 12.6 months. After repair, Japanese Orthopaedic Association scores were increased, showing significant differences compared with＆nbsp;pre-treatment （P〈0.05）. No recurrence or severe complications appeared during fol ow-up. Al patients were rechecked using X-ray within 5 days after repair. Results showed that the internal fixation and bone graft fusion were good. Final fol ow-up radiographs revealed that bone healing was good, and the spine was stable. Above data confirmed that on the basis of triple-drug therapy, debridement and interbody fusion and internal fixation for treating lumbar brucel ar spondylitis can maintain spinal stability, reduce complications, and obtain reliable repair effects.
出处
《中国组织工程研究》
CAS
北大核心
2015年第9期1388-1392,共5页
Chinese Journal of Tissue Engineering Research
