摘要
目的分析胸椎和腰椎结核及3种手术入路,确定脊柱结核手术的入路选择。方法收集54例短程化疗联合病灶清除植骨融合术的脊柱结核患者手术时间,术中出血,后凸畸形的矫正角度和椎体高度的重建等数据作为评估指标。组间均数的差别采用单向方差分析。结果前后联合入路组手术时间大于前路组(P<0.05)。前路组椎高重建大于后路组或前后联合入路组(P<0.05)。胸椎结核联合入路组的术中出血大于前路组或后路组(P<0.05),腰椎结核无此差异(P>0.05)。结论前路手术适合椎体破坏严重伴塌陷,有待重建椎体高度的脊柱结核,前后联合入路因其较长的手术时间不适合基础情况较差的患者,但较长的手术时间并没有明显增加腰椎结核的术中出血。
Objective To analyze the three different operative approaches for thoracic and lumbar spinal tuberculosis, so as to determine the optimal operative approach to treat spinal tuberculosis. Methods Fifty-five patients with spinal tuberculosis who received anti-tuberculo- sis drug and surgical therapy were recruited. The clinical data of patients were collected including surgical time, blood loss,kyphosis correc- tion and vertebra height reconstruction. Differences of means within groups were statistically evaluated by one-way analysis of variance. Re- sults The surgery time in combined anterior and posterior approach （CAPA） group was longer than that in anterior approach （AA） group （P 〈 0.05 ） ; the average vertebral body height reconstruction in AA group was larger than that in posterior approach （PA） or CAPA group （P 〈 0.05 ）, no such difference was found in lumbar spinal tuberculosis. Conclusion AA is suitable for the serious vertebral collapse that needs reconstruction of the height of vertebrae. CAPA was not suitable for the patients with poor basic condition because of the prolonged op- eration time, but the extended operation time were not associated with obviously increased blood loss in lumbar spinal tuberculosis.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2013年第3期253-256,共4页
Journal of China Medical University
基金
广东省自然科学基金(S2012010009374)
关键词
脊柱结核
手术入路
后凸畸形
椎高重建
spinal tuberculosis
operative approach
kyphosis
vertebra height reconstruction
