摘要
目的 探讨自体碎骨作为椎间植骨材料用于治疗腰椎间隙非特异性感染的临床疗效.方法 收集了 2010～2019年该科室采用自体碎骨用于椎体间植骨和后路手术治疗腰椎间隙非特异性感染病例24 例,男性 14 例、女性 10 例,记录患者术前及末次随访时的白细胞计数、红细胞沉降率、C反应蛋白等实验室指标及手术中相关指标、术后并发症.测量术前及末次随访时的邻椎高度,记录病变椎间隙的融合时间.采用视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Os-westry disability index,ODI)评估腰部疼痛及功能障碍程度.结果 所有患者顺利完成手术.细菌培养结果:阳性 8 例(8/24,33.3%),其中革兰氏阳性菌5 例:金黄色葡萄球菌4 例,表皮葡萄球菌 1 例;革兰氏阴性菌 3 例,均为大肠埃希菌.ODI指数由术前(71.46±5.14)%下降至末次随访的(20.83±4.34)%,差异有统计学意义(P＜0.05);VAS评分由术前(6.25±1.36)分下降至末次随访的(2.63±0.88)分,差异有统计学意义(P＜0.05).所有病例均获得椎体间骨性融合.结论 自体碎骨作为椎间植骨材料应用于后路手术治疗非特异性腰椎间隙感染,一方面可以避免取髂骨术带来的损伤和并发症,另一方面能够维持和恢复椎体间高度,获得椎体间骨性融合,取得良好的临床效果.
Abstract
Objective To investigate the safety and clinical efficacy of autografting crushed bone by TILF in the treatment of lum-bar intervertebral pyogenic infection.Methods The clinical data of 24 cases(14 males and 10 females)with autografting crushed bone by TILF in the treatment of lumbar intervertebral pyogenic infection were collected from 2010 to 2019.WBC,erythrocyte sedi-mentation rate(ESR)and C-reactive protein(CRP)level of patients at preoperative and follow-up visit,intraoperative related indica-tors and complications were recorded.The height of the adjacent vertebrae was measured at preoperative and follow-up visit.Imaging examinations were taken to evaluate the fusion of vertebral body,The clinical effects were evaluated using the visual analog scale(VAS)and the degree of lumbar pain and disability was assessed uisng Oswestry disability index(ODI).Results All patients com-pleted the operation successfully.Results of bacterial culture showed that there were 8 cases of positive culture(8/24,33.3%),in which 5 cases were gram-positive bacteria,4 cases were Staphylococcus aureus and one was staphylococcus epidermococcus.Three gram-negative bacteria were escherichia coli.The ODI score decreased from preoperative(71.46±5.14)%to the last follow-up(20.83±4.34)%,and the difference was statistically significant(P＜0.05).VAS score decreased from(6.25±1.36)before oper-ation to(2.63±0.88),and the difference was statistically significant(P＜0.05).Intervertebral fusion was obtained in all cases.Conclusion The application of autografting crushed bone by TILF in the treatment of lumbar intervertebral pyogenic infection can a-void the complications caused by ilium extraction and obtain satisfactory clinical results.
维普
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