本文選題：后路釘棒內(nèi)固定　切入點(diǎn)：胸腰椎結(jié)核　出處：《安徽醫(yī)學(xué)》2016年11期 　論文類(lèi)型：期刊論文

【摘要】：目的探討單純后路釘棒內(nèi)固定治療早中期胸腰椎結(jié)核的療效。方法回顧性分析2008年10月至2014年10月安徽醫(yī)科大學(xué)第二附屬醫(yī)院收治的35例胸腰椎結(jié)核患者的臨床資料,根據(jù)手術(shù)不同術(shù)式分為A組前路植骨融合內(nèi)固定組(20例)和B組后路釘棒內(nèi)固定組(15例),分析兩組手術(shù)時(shí)間、出血量、住院天數(shù)、術(shù)前術(shù)后及末次隨訪時(shí)的后凸角(Cobb角)、疼痛視覺(jué)評(píng)分(VAS評(píng)分)、Oswestry功能障礙問(wèn)卷表(ODI評(píng)分)及神經(jīng)功能恢復(fù)情況(Frankel分級(jí))。35例患者均獲隨訪。結(jié)果隨訪12~24個(gè)月,平均18個(gè)月。B組在手術(shù)時(shí)間、出血量及住院天數(shù)方面均低于A組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。A組Cobb角術(shù)后為(8.47±1.67)°較術(shù)前(13.28±3.12)°減小,VAS評(píng)分術(shù)后為(2.30±1.10)分較術(shù)前(7.10±1.20)分改善,ODI評(píng)分術(shù)后(13.70±3.50)分較術(shù)前(43.80±5.50)分改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。B組Cobb角術(shù)后(5.37±2.21)°較術(shù)前(13.83±4.54)°減小,VAS評(píng)分術(shù)后(1.90±1.20)分較術(shù)前(7.10±1.10)分減少,ODI評(píng)分術(shù)后(13.90±3.10)分較術(shù)前(41.10±5.30)分減少,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組組間手術(shù)前的Cobb角、手術(shù)前后VAS評(píng)分及ODI評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。B組在Cobb角矯正及防止丟失上優(yōu)于A組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。根據(jù)Frankel分級(jí),A組術(shù)前D級(jí)7例,E級(jí)13例,術(shù)后D級(jí)3例,E級(jí)17例,術(shù)前B組D級(jí)5例,E級(jí)10例,術(shù)后E級(jí)15例,兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論單純后路釘棒內(nèi)固定,不做病灶清除,其療效優(yōu)于植骨融合內(nèi)固定,是治療早中期脊柱結(jié)核的有效方法之一。
[Abstract]:Objective to evaluate the efficacy of posterior screw rod fixation in the treatment of thoracolumbar tuberculosis in early and middle stage. Methods from October 2008 to October 2014, 35 patients with thoracolumbar tuberculosis treated in the second affiliated Hospital of Anhui Medical University were retrospectively analyzed. According to the different operation methods, the patients were divided into two groups: group A (20 cases) and group B (15 cases). The operation time, blood loss and hospital stay were analyzed. All the patients were followed up before and after operation and at the last follow-up. All the patients were followed up for 12 ~ 24 months. The visual score of pain and the VAS score and the Oswestry dysfunction scale (Oswestry dysfunction questionnaire) and the recovery of nerve function were all followed up in 35 patients with Frankel grade. The mean operation time, bleeding volume and hospital stay in group B were lower than those in group A. The difference was statistically significant (P 0.05 鹵1.20): the Cobb angle after operation was 8.47 鹵1.67 擄lower than that before operation (13.28 鹵3.12) 擄. The score was 2.30 鹵1.10) after operation, and the score was improved by 13.70 鹵3.50% than that of 43.80 鹵5.50% before operation, compared with the preoperative score of 7.10 鹵1.20 (P 0.05 鹵1.20). The difference was statistically significant (P 0.05 鹵2.21 擄vs 13.83 鹵4.54 擄, P 0.05 鹵2.21 擄, P 0.05 鹵4.54 擄, P 0.05 鹵4.54 擄, P < 0.05). The Cobb angle before operation was significantly lower in group B than that in group B (P < 0.05), and the score was lower than that in group B (P < 0.05), and the score of Cobb before operation was significantly lower than that in group B (P < 0.05), and the score of Cobb before operation was significantly lower than that in group B (P < 0.05). There was no significant difference in VAS score and ODI score before and after operation. Group B was superior to group A in Cobb angle correction and loss prevention, and the difference was statistically significant (P 0.05). According to Frankel classification, there were 7 cases of grade D and 17 cases of grade E before operation in group A, and 17 cases in group D after operation. In group B, there were 5 cases of grade D and 15 cases of grade E before operation. There was no significant difference between the two groups (P 0.05). Conclusion the curative effect of simple posterior screw rod fixation without debridement is better than that of bone graft fusion internal fixation. It is one of the effective methods for the treatment of spinal tuberculosis in early and middle stage.
【作者單位】： 安徽醫(yī)科大學(xué)第二附屬醫(yī)院骨科;
【分類(lèi)號(hào)】：R687.3

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