Objective To investigate the therapeutic effect of different debridement approaches combined with internal fixation with bone grafting in Brucellar spondylitis.Methods A retrospective study was conducted on 68 patients with Brucellar spondylitis.The 34 patients receiving one-stage posterior debridement+bone graft fusion+pedicle screw rod internal fixation were included in group A,while the other 34 patients treated with one-stage anterior debridement+bone graft fusion+pedicle screw rod internal fixation were included in group B.After 1 year of follow-up,3 cases in group B and 1 case in group A fell off.The two groups were compared for biomechanical indexes,clinical indexes,blind imaging scores and complications.Results The operation time,the first time of getting out of bed,the length of hospitalization and the intraoperative blood loss were shorter/less in group A than in group B(P<0.05).The differences in blind imaging score,Cobb angle and anterior vertebral body height ratio before operation and 1,6 and 12 months after operation,as well as the visual analogue scale score for low back pain before operation and 6 and 12 months after operation between two groups were trivial(P>0.05).One month after operation,the visual analogue scale score for low back pain in group A was lower than that in group B(P<0.05).Significant difference between two groups was found in ASIA grades at 12 months after operation(P<0.05)but not at 6 months after operation(P>0.05).No serious complications occurred in both groups,and patients'condition improved after active intervention.Conclusion Both debridement approaches can effectively improve clinical symptoms,maintain spinal stability,facilitate graft fusion,and control postoperative inflammation.However,the posterior approach can shorten the operation time,reduce the trauma to the body,and significantly alleviate pain at 1 month after operation,especially improving the symptoms of spinal cord nerve compression in the spinal canal,so it can be preferred if patient's condition permits.
关键词
布鲁杆菌性脊柱炎/腰椎/病灶清除术/植骨融合/椎弓根钉棒内固定术/生物力学/神经功能
Key words
Brucellar spondylitis/lumbar vertebra/lesion debridement/graft fusion/pedicle screw rod internal fixation/biomechanics/neural function
维普
万方数据