单纯后路病灶清除植骨内固定治疗成人腰椎结核的可行性及临床疗效

蔚青松

（陕西省陇县中医医院，陕西 宝鸡，721200）

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摘要：

目的 评价单纯进行后路病灶清除植骨内固定治疗成人腰椎结核的可行性及临床疗效。方法 选择2010年1月至2016年3月我院收治的腰椎结核病患者127例，对其采用后路病灶清除、植骨内固定的方法进行治疗，分析其VAS评分、结核活动情况及植骨融合等情况。结果 治疗后，手术平均时间为（200.34±15.23）min，出血量为（1 248.78±128.55）mL，住院时间为（25.62±3.19）d，手术过程安全，未发生伤及血管、神经等情况。患者在经过一段时间的康复治疗后，治疗效果良好，植骨基本能够实现完全融合；治疗前患者的VAS评分为（8.56±2.12）分，治疗后为（1.34±0.56），差异具有统计学意义（P<0.05）。治疗前后凸Cobb 角为（22.56°±2.37°），治疗后为（4.67°±1.24°），差异具有统计学意义（P<0.05）。结论 对腰椎结核患者实施后路病灶清除、植骨内固定治疗，可实现对病灶清除、植骨与人体融合好的效果，且无不良反应发生，可推荐用于腰椎结核患者的临床 治疗中。

关键词：后路病灶；植骨；腰椎结核

中图分类号：R687.3文献标志码：A文章编号：2096-1413(2017)08-0085-02

Feasibility and clinical efficacy of one stage posterior focal cleaning with instrumentation and fusion in the treatment of adult lumbar tuberculosis
YU Qing-song
(TCM Hospital of Long County, Baoji 721200, China)

ABSTRACT: Objective To evaluate the feasibility and clinical efficacy of one stage posterior focal cleaning with instrumentation and fusion in the treatment of adult lumbar tuberculosis. Methods One hundred and twenty-seven cases with lumbar tuberculosis in our hospital from January 2010 to March 2016 were selected and treated with one stage posterior focal cleaning with instrumentation and fusion. The VAS score, situation of tuberculosis activity and bone graft fusion were analyzed. Results After surgery, the average operating time was (200.34±15.23) min，the blood loss was (1 248.78±128.55) mL, the hospitalization time was (25.62±3.19) d. The surgery was safe, and vessels or nerves were not injured. After a period of rehabilitation treatment, the treatment effect is also ideal, and the bone graft achieved complete fusion. Before the treatment, the VAS score of patients was (8.56±2.12), while the VAS score was (1.34±0.56) after the treatment, the difference was statistically significant (P<0.05). The convex Cobb angle was (22.56° ±2.37° ) before the treatment, and (4.67°±1.24°) after the treatment, the difference was statistically significant (P<0.05). Conclusion Posterior focal cleaning with instrumentation and fusion can achieve the effect that lesions are cleared, and there is a good combination of bone graft and the human body of in the treatment of lumbar tuberculosis without adverse reactions. It is effective in the treatment of patients with lumbar tuberculosis
KEYWORDS: posterior lesion; bone grafting; lumbar tuberculosis

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