Five-year outcomes of posterior affected-vertebrae fixation in lumbar tuberculosis patients.
Five-year outcomes of posterior affected-vertebrae fixation in lumbar tuberculosis patients.
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腰椎结核患者后路受影响椎体固定的五年结果
DOI：
10.1186/s13018-018-0902-2
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发表时间：
2018-08-22
影响因子：
2.6
通讯作者：
Wang Z
中科院分区：
文献类型：
--
作者：
Liang Q;Wang Q;Sun G;Ma W;Shi J;Jin W;Shi S;Wang Z
研究背景腰椎结核畸形矫正后后路内固定是重建脊柱稳定性的重要方法。然而，常用的方法包括正常运动单位的长节段和短节段固定。有没有关于受影响的椎骨固定的腰椎TB。MethodsData从135例腰椎TB谁进行了后路器械和受影响的椎骨固定或短节段固定，采用前后联合入路进行了回顾性分析。其中71例采用患椎固定，64例采用短节段固定。在所有受累节段内进行了清创、植骨、畸形矫正和减压。手术时间，术中出血量，结核治愈率，植骨融合率，畸形矫正程度，神经功能，疼痛恢复，并发症进行了分析。固定节段总数为107 vs. 226;平均固定节段数为1.51 vs. 3.53;平均失血量为726.2 ml vs. 948.5 ml;平均手术时间为210.4 min vs. 270.3 min;平均住院费用分别为2.9万元和4.2万元（P均< 0.05）。患椎固定组和短节段固定组术后6个月结核治愈率分别为82.61%和84.62%，术后5年结核治愈率分别为97.83%和97.44%;术后6个月骨融合率分别为86.96%和87.18%，术后5年骨融合率分别为97.83%和97.66%，Cobb角平均矫正度分别为13.1°和13.7°;结论在严格掌握手术指征的前提下，采用后路内固定治疗腰椎结核是一种安全、有效、可行的固定方法。
BackgroundPosterior instrumentation after deformity correction is an important method for reconstruction of spinal stability in the management of lumbar tuberculosis (TB). However, the commonly used methods include both long- and short-segment fixation of normal motor units. There has been no report regarding affected-vertebrae fixation of lumbar TB.MethodsData from 135 patients with lumbar TB who underwent posterior instrumentation and either affected-vertebrae fixation or short-segment fixation using a combined posterior and anterior approach were retrospectively reviewed. Among these patients, 71 cases were treated with affected-vertebrae fixation, and 64 cases were treated with short-segment fixation. Debridement, bone grafting, deformity correction, and decompression were performed within all affected segments. Operative times, intra-operative blood loss, TB cure rates, bone graft fusion rates, degree of deformity correction, neurological function, pain recovery, and complications were analyzed.ResultsComparing affected-vertebrae fixation vs. short-segment fixation groups, respectively, the number of the affected segments was 107 vs. 98; average number of affected segments was 1.51 vs. 1.53; total number of fixed segments was 107 vs. 226; average number of fixed segments was 1.51 vs. 3.53; average blood loss was 726.2 ml vs. 948.5 ml; average operative time was 210.4 min vs. 270.3 min; and average hospitalization costs were 29,000 RMB vs. 42,000 RMB (allpvalues < 0.05). In the affected-vertebrae fixation vs. short-segment fixation groups, respectively, TB cure rates were 82.61% vs. 84.62% at 6 months after operation and 97.83% vs. 97.44% at 5 years after operation; bone fusion rates were 86.96% vs. 87.18% at 6 months after operation and 97.83% vs. 97.66% at 5 years after operation; average number of degrees of Cobb’s angle correction were 13.1° vs. 13.7°; average correction losses were 1.9° vs. 1.4°; and complication rates were 12.04% vs. 12.97% (allpvalues > 0.05).ConclusionUnder strict surgical indications, posterior instrumentation on affected-vertebrae is a safe, effective, and feasible fixation method in the treatment of lumber TB.
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影响因子：
2.8
作者：
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通讯作者：
Elmorshidy, Essam
影响因子：
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通讯作者：
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影响因子：
2.3
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通讯作者：
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