The outcome of intervertebral surgery in the treatment of lumbar tuberculosis in children: A case series and long-term follow-up
The outcome of intervertebral surgery in the treatment of lumbar tuberculosis in children: A case series and long-term follow-up
复制标题
椎间手术治疗儿童腰椎结核的疗效：病例系列及长期随访
DOI：
10.1097/md.0000000000014815
复制
发表时间：
2019-03-01
期刊：
影响因子：
1.6
通讯作者：
Wang, Zili
中科院分区：
文献类型：
--
作者：
Liang, Qiang;Pu, Yu;Wang, Zili
治疗小儿腰椎结核手术中多采用长节段或短节段固定、融合的方法，这会对正常运动单位的功能产生不利影响。因此，我们一直关注如何通过椎间手术缩短固定和融合的范围。本回顾性研究的目的是探讨椎间手术治疗儿童腰椎结核的临床效果。2003年6月至2013年6月，我院对18例腰椎结核患儿进行了前后路联合椎间手术治疗。手术治疗包括受影响椎体的后路椎弓根螺钉固定和后外侧植骨、前路清创、加压和支撑植骨。对术前、术后红细胞沉降率（ESR）、C反应蛋白（CRP）水平、神经功能、视觉模拟量表（VAS）评分、后凸Cobb角、并发症、病灶愈合、植骨愈合、复发等指标进行统计分析。平均随访时间86.5个月（62～120个月）。术后三个月，所有患者的ESR和CRP水平均降至正常，美国脊柱损伤协会神经功能评分和VAS评分均有所改善。植骨成功愈合，术后6个月病灶完全愈合，未出现复发。术前后凸为24.00°13.15°（范围-10°-39°），术后下降至-4.61°+/-7.31°（范围-19°-10°）（Z=-4.34，P
During the operation of treating lumbar tuberculosis in children, a long-segment or short-segment fixation, and fusion method were usually applied, which would adversely affect the function of normal motion unit. And so, we have been focusing on how we can shorten the range of fixation and fusion using intervertebral surgery. The objective of this retrospective study is to investigate the clinical outcome of intervertebral surgery, in the treatment of lumbar tuberculosis in children.From June 2003 to June 2013, 18 children with lumbar tuberculosis underwent intervertebral surgery, using a combined posterior and anterior approach, in our hospital. The surgical treatments included posterior pedicle screw fixation of affected vertebrae and posterolateral bone grafting, anterior debridement, compression, and strut bone grafting. Indicators such as preoperative and postoperative erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, neurological function, visual analog scale (VAS) score, kyphotic Cobb angle, complications, healing of lesions, bone graft healing, and recurrence were statistically analyzed.The mean follow-up time was 86.5 months (range, 62-120 months). Three months after the operation, all patients' ESR and CRP levels decreased to normal, and both the American Spinal Injury Association neurological function scores and VAS scores improved. Successful bone graft healing was achieved, with lesions completely healed at 6 months after surgery, and no recurrence occurred. The preoperative kyphotic was 24.00 degrees 13.15 degrees (range -10 degrees-39 degrees), which decreased to -4.61 degrees +/- 7.31 degrees (range -19 degrees-10 degrees) postoperative (Z=-4.34, P