摘要
目的比较前后联合入路与后路手术治疗脊柱结核的疗效。方法将106例脊柱结核患者按手术入路方式的不同分为后路组(采用后路手术,53例)和联合入路组(采用前后联合入路手术,53例)。记录两组手术情况,比较两组手术前后脊髓神经功能分级(ASIA分级)、红细胞沉降率(ESR)、Cobb角、术后并发症发生情况。结果患者均获得随访,时间12~18个月。手术时间、术中出血量联合入路组长(多)于后路组,差异均有统计学意义(P<0.001);住院天数两组比较差异无统计学意义(P>0.05)。术后1年ASIA分级两组均较术前改善(P<0.05),联合入路组优于后路组(P<0.05)。两组ESR及Cobb角术后1周均较术前降低(P<0.05)。术后并发症发生率两组比较差异无统计学意义(P>0.05)。结论与后路相比,前后联合入路手术治疗脊柱结核手术时间长、出血量多,但患者术后脊髓神经功能恢复更佳。
Objective To compare the effect of combined anterior and posterior approaches and posterior approach in the treatment of spinal tuberculosis.Methods The 106 patients with spinal tuberculosis were divided into posterior approach group(53 cases underwent posterior approach)and combined approaches group(53 cases underwent combined anterior and posterior approaches).The operation conditions of the two groups were recorded,and the spinal cord nerve function classification(ASIA classification),erythrocyte sedimentation rate(ESR),Cobb angle and postoperative complications were compared between the two groups.Results All patients were followed up for 12~18 months.The operation time and intraoperative blood loss in the combined approaches group were longer(more)than the posterior approach group(P<0.001),but there was no significant difference in hospital stay between the two groups(P>0.05).At 1 year after operation,ASIA classification in both groups were improved than the preoperation(P<0.05),and the combined approaches group was better than the posterior approach group(P<0.05).ESR and Cobb angle of the two groups were decreased than those at 1 week postoperation(P<0.05).There was no significant difference in the incidence rate of postoperative complications between the two groups(P>0.05).Conclusions Compared with the posterior approach surgery,the combined anterior and posterior approaches surgery have longer operation time and more blood loss,but the recovery of spinal cord nerve function is better.
作者
陈崇阳
尹锐
周文来
CHEN Chong-yang;YIN Rui;ZHOU Wen-lai(SectionⅡ,Dept of Orthopaedics,the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi,Hubei 445000,China)
出处
《临床骨科杂志》
2021年第1期25-29,共5页
Journal of Clinical Orthopaedics
关键词
胸腰椎结核
手术入路
病灶清除
后路内固定
thoracolumbar tuberculosis
surgical approach
lesion removal
posterior internal fixation
