中国组织工程研究

中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (9): 1388-1392.doi: 10.3969/j.issn.2095-4344.2015.09.013

• 脊柱植入物 spinal implant • 上一篇    下一篇

植骨融合内固定修复腰椎布鲁杆菌性脊柱炎：6个月随访脊柱稳定性

牛广续1，卡哈尔•艾肯木2，赵  疆2，楚  戈2，王振斌2，顾文飞2，涂来勇2   

  1. 1新疆兵团七师医院，新疆维吾尔自治区奎屯市  833200
    2新疆医科大学附属中医医院，新疆维吾尔自治区乌鲁木齐市  830000
  • 修回日期:2014-12-31 出版日期:2015-02-26 发布日期:2015-02-26
  • 通讯作者: 赵疆，主任医师，新疆医科大学附属中医医院，新疆维吾尔自治区乌鲁木齐市 830000
  • 作者简介:牛广续，男，1970年生，山东省单县人，汉族，1993年石河子医学院毕业，副主任医师，主要从事脊柱外科研究。

Bone fusion and fixation in the repair of lumbar brucellar spondylitis: spinal stability in 6-month follow-up

Niu Guang-xu1, Kahaer•Aikenmu2, Zhao Jiang2, Chu Ge2, Wang Zhen-bin2, Gu Wen-fei2, Tu Lai-yong2   

  1. 1Xinjiang Corps Seven Division Hospital, Kuitun 833200, Xinjiang Uygur Autonomous Region, China
    2Affiliated Hospital of Chinese Medicine, Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
  • Revised:2014-12-31 Online:2015-02-26 Published:2015-02-26
  • Contact: Zhao Jiang, Chief physician, Affiliated Hospital of Chinese Medicine, Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
  • About author:Niu Guang-xu, Associate chief physician, Xinjiang Corps Seven Division Hospital, Kuitun 833200, Xinjiang Uygur Autonomous Region, China

PDF

625

摘要：

背景：布鲁杆菌性脊柱炎单纯病灶清除植骨融合术后卧床时间长，患者起床活动后容易诱发脊柱不稳，植骨不愈合率较高，疗效不佳。
目的：探讨采用病灶清除椎间植骨融合内固定修复腰椎布鲁杆菌病脊柱炎、稳定脊柱结构的疗效。
方法：2007年1月至2013年8月新疆医科大学附属中医医院收治腰椎布鲁杆菌病性脊椎炎患者31例，男22例，女9例；年龄42-73岁，平均52岁；病程3-13个月，平均5个月。所有患者在利福平和米诺环素及链霉素联合药物治疗的基础上，采取一期病灶清除植骨融合，脊柱钉棒系统内固定。比较患者手术前后JOA评分评价预后及功能恢复情况，随访X射线片观察植骨融合情况。
结果与结论：所有患者均获6-24个月的随访，平均随访12.6个月。患者修复后JOA评分较治疗前提高，差异有显著性意义(P < 0.05)；随访期间无复发及严重并发症发生；修复后5 d内复查X射线片，见所有患者植骨及内固定位置良好，末次随访X射线片显示植骨愈合良好，脊柱稳定。提示腰椎布氏菌杆性脊柱炎在三联药物治疗的同时，行病灶清除椎间植骨融合内固定治疗，能维持脊柱稳定性、减少并发症，可取得可靠的修复效果。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

关键词: 植入物, 脊柱植入物, 布鲁杆菌脊柱炎, 腰椎, 诊断, 药物治疗, 内固定, 脊柱稳定性, 植骨融合

Abstract:

BACKGROUND: After simple debridement and fusion of brucella spondylitis, bed time is long. Activities are likely to cause spinal instability. Bone nonunion rate is very high, and the curative effects are poor.
OBJECTIVE: To investigate the efficacy of debridement and interbody fusion fixation for repair of lumbar brucellar spondylitis and for stable spine structure.
METHODS: A total of 31 cases of lumbar brucellar spondylitis were obtained from Affiliated Hospital of Chinese Medicine, Xinjiang Medical University between January 2007 to August 2013, including 22 males and 9 females, at the age of 42-73 years, averagely 52 years. Their course of disease was 3-13 months, averagely 5 months. All patients were administered combination therapy of rifampin and minocycline and streptomycin, and then received one-stage debridement and fusion, spinal pedicle screw fixation system. Japanese Orthopaedic Association scores were compared before and after the surgery for assessing prognosis and functional recovery. Bone fusion was observed using X-ray during follow-up. 
RESULTS AND CONCLUSION: All patients were followed up for 6-24 months, averagely 12.6 months. After repair, Japanese Orthopaedic Association scores were increased, showing significant differences compared with pre-treatment (P < 0.05). No recurrence or severe complications appeared during follow-up. All patients were rechecked using X-ray within 5 days after repair. Results showed that the internal fixation and bone graft fusion were good. Final follow-up radiographs revealed that bone healing was good, and the spine was stable. Above data confirmed that on the basis of triple-drug therapy, debridement and interbody fusion and internal fixation for treating lumbar brucellar spondylitis can maintain spinal stability, reduce complications, and obtain reliable repair effects.


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

Key words: Brucellosis, Spondylitis, Bone Transplantation

中图分类号: