The clinical outcomes of surgical treatment of noncontiguous spinal tuberculosis: a retrospective study in 23 cases.
The clinical outcomes of surgical treatment of noncontiguous spinal tuberculosis: a retrospective study in 23 cases.
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非连续性脊柱结核手术治疗的临床疗效：23例回顾性研究。
DOI：
10.1371/journal.pone.0093648
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Gao Q
中科院分区：
文献类型：
--
作者：
Huang J;Zhang H;Zeng K;Gao Q
回顾性临床研究。目的评价非连续性脊柱结核（NSTB）手术治疗的临床疗效，并探讨其治疗策略。我们对2005年6月至2011年6月期间在我院诊断并治疗的550例连续脊柱结核患者的临床和影像学资料进行了回顾性分析。除4例患者接受保守治疗外，其余患者在单期或两期手术中接受后路经椎间孔清创、椎间融合内固定、后路内固定和前路清创融合手术。从血液学和影像学检查、骨融合和神经系统状况等方面评价治疗前后的临床结果。在治疗前和最后一次随访时测定Oswestry残疾指数评分。23例患者（15 M/8F），平均44.6±14.2岁（范围19 ~ 70 yd），接受手术治疗，术后平均随访52.5±19.5个月（范围24 ~ 72个月）。手术前后脊柱后凸角度变化明显（P<0.05）。平均矫正量为12.6±7.2度，末次随访时矫正量损失较小。所有患者均实现了实骨融合。无患者术后神经功能缺损恶化。没有发现死亡或任何重大并发症。术前与最终随访的Oswestry残疾指数评分差异有统计学意义。随访结果显示，后路和后前路手术治疗方法均为NSTB可行的手术选择。后路经椎间孔清创、椎间融合术和后路内固定术作为一种侵入性较小的技术，对于治疗特定的结节灶是可行和有效的。
A retrospective clinical study. To evaluate the clinical efficacy of the surgical treatment of noncontiguous spinal tuberculosis (NSTB), and to discuss its therapeutic strategies. We performed a retrospective review of clinical and radiographic data that were prospectively collected on 550 consecutive spinal tubercular patients including 27 patients who were diagnosed and treated as NSTB in our institution from June 2005 to June 2011. Apart from 4 patients being treated conservatively, the remainder received surgery by posterior transforaminal debridement, interbody fusion with instrumentation, posterior instrumentation and anterior debridement with fusion in a single or two-stage operation. The clinical outcomes were evaluated before and after treatment in terms of hematologic and radiographic examinations, bone fusion and neurologic status. The Oswestry Disability Index score was determined before treatment and at the last follow-up visit. 23 patients (15 M/8F), averaged 44.6±14.2 years old (range, 19 to 70 yd), who received surgical treatment, were followed up after surgery for a mean of 52.5±19.5 months (range, 24 to 72 months). The kyphotic angle was changed significantly between pre- and postoperation (P<0.05). The mean amount of correction was 12.6±7.2 degrees, with a small loss of correction at last follow-up. All patients achieved solid bone fusion. No patients with neurological deficit deteriorated postoperatively. Neither mortalities nor any major complications were found. There was a significant difference of Oswestry Disability Index scores between preoperation and the final follow-up. The outcomes of follow-up showed that posterior and posterior-anterior surgical treatment methods were both viable surgical options for NSTB. Posterior transforaminal debridement, interbody fusion and posterior instrumentation, as a less invasive technique, was feasible and effective to treat specific tubercular foci.
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影响因子：
4.1
作者：
Lee, TC;Lu, K;Liang, CL
通讯作者：
Liang, CL
影响因子：
2.7
作者：
Shi, Jian-Dang;Wang, Zi-Li;Niu, Ning-Kui
通讯作者：
Niu, Ning-Kui
影响因子：
5
作者：
BUCKNER, CB;LEITHISER, RE;ALLISON, JW
通讯作者：
ALLISON, JW
影响因子：
3
作者：
MOON, MS;WOO, YK;SUN, DH
通讯作者：
SUN, DH
影响因子：
2.8
作者：
Turgut, M
通讯作者：
Turgut, M