内固定治疗原发性胸腰椎化脓性感染的效果
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摘要
目的:探讨内固定治疗原发性胸腰椎化脓性感染的临床疗效。方法:选取2010年1月至2017年12月深圳市第二人民医院收治的原发性胸腰椎化脓性感染患者27例,患者均采用一期固定,自体髂骨植骨,病灶清除手术,对比术前与术后各项感染指标及影像学表现进行临床疗效分析。结果:患者术前与术后2周,术后6个月白细胞(WBC),红细胞沉降率(ESR),C反应蛋白(CRP),降钙素原(PCT),视觉模拟评分法(VAS),日本骨科协会(JOA)评分评估治疗,脊柱后凸角度(Cobb角),组间比较,差异具有统计学意义(P<0.05)。结论:内固定应用于脊柱化脓性感染是安全而有效的。
Objective To assess the clinical effect of internal fixation on the treatment of primary pyogenic infection of thoracic and lumbar spine. Methods Twenty-seven patients with primary thoracolumbar septic infection admitted to Shenzhen second people's hospital from January 2010 to December 2017 were selected.Patients were treated with one-stage fixation, autologous iliac bone grafting, and lesion removal surgery.The clinical efficacy of the preoperative and postoperative infection indicators and imaging findings were compared. Result The difference in WBC(white blood cell),ESR(erythrocyte sedimentation rate),CRP(C-reactive protein), PCT(procalcitonin),VAS score(visual analogue scale score), JOA score(Japanese Orthopaedic Association Score) and cobb angles(spine kyphosis angle) were statistically significant before surgery,2 weeks after surgery and 6 months after surgery. Conclusion Internal fixation is safe and effective for primary pyogenic infection.
Objective To assess the clinical effect of internal fixation on the treatment of primary pyogenic infection of thoracic and lumbar spine. Methods Twenty-seven patients with primary thoracolumbar septic infection admitted to Shenzhen second people's hospital from January 2010 to December 2017 were selected.Patients were treated with one-stage fixation, autologous iliac bone grafting, and lesion removal surgery.The clinical efficacy of the preoperative and postoperative infection indicators and imaging findings were compared. Result The difference in WBC(white blood cell),ESR(erythrocyte sedimentation rate),CRP(C-reactive protein), PCT(procalcitonin),VAS score(visual analogue scale score), JOA score(Japanese Orthopaedic Association Score) and cobb angles(spine kyphosis angle) were statistically significant before surgery,2 weeks after surgery and 6 months after surgery. Conclusion Internal fixation is safe and effective for primary pyogenic infection.
引文
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[9]Shad A,Shariff S,Fairbank J,et al.Internal fixation for osteomyelitis of cervical spine:the issue of persistence of culture positive infection around the implants[J].Acta Neurochir(Wien),2003,145(11):957-960.
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[11]Hee HT,Majd ME,Holt RT,et al.Better treatment of vertebral osteomyelitis using posterior stabilization and titanium meshcages[J].Journal of spinal disorders&techniques,2002,15(2):149-156.
[12]Korovessis P,Petsinis G,Koureas G,et al.One-stage Combined Surgery with Mesh Cages for Treatment of Septic Spondylitis[J].Clin Orthop Relat Res,2006,444(444):51-59.
[13]Schuster JM,Avellino AM,Mann FA,et al.Use of structural allografts in spinal osteomyelitis:a review of 47cases[J].J Neurosurg,2000,93(1):8-14.
[2]孙厚杰,蔡小军,韩建华,等.非特异性脊柱感染的诊断与治疗[J].中国脊柱脊髓杂志,2013,23(6):508-513.
[3]Walters R,Verong-Roberts B,Ffaser R,et al.Therapeutic use of cephazolin to prebent complications of spine surgery[J].Infl ammopharmacology,2006,14(3):138-143.
[4]Cornett CA,Vincent SA,Crow J,et al.Bacterial Spine Infections in Adults:Evaluation and Management[J].J Am Acad Orthop Surg,2016,24(1):11-18.
[5]唐焕章,徐皓,姚晓东,等.一期病灶清除植骨内固定治疗原发性椎间隙感[J].中国矫形外科杂志,2008,16(13):969-972.
[6]Lim JK,Kim SM,Jo DJ,et al.Anterior interbody grafting and instrumentation for advanced spondylodiscitis[J].J Korean Neurosurg Soc,2008,43(1):5-10.
[7]Fukuta S,Miyamoto K,Masuda T,et al.Two-stage(posterior and anterior)surgical treatment using posterior spinal instrumentation for pyogenic and tuberculotic spondylitis[J].Spine,2003,28(15):E302-308.
[8]Hodgson AR,Stock FE.Anterior spinal fusion a preliminary communication on the radical treatment of Pott's disease and Pott's paraplegia[J].Br J Surg,1956,44(185):266-275.
[9]Shad A,Shariff S,Fairbank J,et al.Internal fixation for osteomyelitis of cervical spine:the issue of persistence of culture positive infection around the implants[J].Acta Neurochir(Wien),2003,145(11):957-960.
[10]A L Bhat,G L Lowery,A Sei.The use of titanium surgical mesh-bone graft composite in the anterior thoracic or lumbar spine after complete or partial corpectomy[J].European spine journal,1999,8(4):304-309.
[11]Hee HT,Majd ME,Holt RT,et al.Better treatment of vertebral osteomyelitis using posterior stabilization and titanium meshcages[J].Journal of spinal disorders&techniques,2002,15(2):149-156.
[12]Korovessis P,Petsinis G,Koureas G,et al.One-stage Combined Surgery with Mesh Cages for Treatment of Septic Spondylitis[J].Clin Orthop Relat Res,2006,444(444):51-59.
[13]Schuster JM,Avellino AM,Mann FA,et al.Use of structural allografts in spinal osteomyelitis:a review of 47cases[J].J Neurosurg,2000,93(1):8-14.