One-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation in treating lumbosacral spinal tuberculosis
One-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation in treating lumbosacral spinal tuberculosis
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DOI：
10.1007/s00402-013-1751-4
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发表时间：
2013-08-01
影响因子：
2.3
通讯作者：
Wang, Xiyang
中科院分区：
文献类型：
--
作者：
Pang, Xiaoyang;Wu, Ping;Wang, Xiyang
回顾性分析2004年1月至2010年1月期间21例腰骶部结核患者，均行一期后路经椎间孔腰椎病灶清除、360 A度椎间融合、后路内固定术，和后路器械。随访16-36个月（平均24.9 ± A6.44个月），根据腰骶角、美国脊髓损伤协会（ASIA）损伤评分、血沉（ESR）、C反应蛋白（CRP）等指标评价疗效。18例患者术前存在明显的神经功能缺损，其中16例患者在末次随访时恢复正常。2例患者术后神经功能障碍加重，神经功能明显部分恢复。经有效、规范的抗结核化疗后，ESR和CRP于术后3个月恢复正常，并维持至末次随访。术前腰骶角为20.89 +/- A 2.32A度，术后恢复为29.62 +/- A 1.41A度。在长期随访中，腰骶角仅丢失1-3A度。腰骶角术前与术后差异有统计学意义，在有效规范的抗结核化疗下，一期后路经椎间孔病灶清除、360 A °椎间融合、后路内固定治疗腰骶部结核，可有效缓解疼痛症状，改善神经功能，重建脊柱稳定性。
Retrospective analysis of the clinical study efficacy and feasibility of one-stage posterior transforaminal lumbar debridement, 360A degrees interbody fusion, and posterior instrumentation in treating lumbosacral spinal tuberculosis.A total of 21 patients with lumbosacral tuberculosis (TB) collected from January 2004 to January 2010, underwent one-stage posterior transforaminal lumbar debridement, 360A degrees interbody fusion, and posterior instrumentation. In addition, the clinical efficacy was evaluated based on the data on the lumbo-sacral angle, neuro-logical status that was recorded by American Spinal Injury Association (ASIA) Impairment Scale, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), which were collected at specific time points.All cases were followed up for 16-36 months (average 24.9 +/- A 6.44 months). 18 patients suffered from evident neurological deficits preoperatively, of which 16 patients returned to normal at the final follow-up. Two patients with neurological dysfunction aggravated postoperative, experienced significant partial neurological recovery. With an effective and standard anti-TB chemotherapy treated, the values of ESR and CRP returned to normal levels 3-month later postoperative and maintained till the final follow-up. Preoperative lumbosacral angle was 20.89 +/- A 2.32A degrees and returned 29.62 +/- A 1.41A degrees postoperative. During long-term follow-up, there was only 1-3A degrees lumbosacral angle loss. There was a significant difference between preoperative and postoperative lumbosacral angles.With effective and standard anti-TB chemotherapy, one-stage posterior transforaminal lumbar debridement, 360A degrees interbody fusion, and posterior instrumentation for lumbosacral tuberculosis can effectively relieve pain symptoms, improve neurological function, and reconstruct the spinal stability.