[1]侯文根,路　坦,张　超,等.单独病灶清除植骨融合与联合后路椎弓根螺钉内固定术治疗胸腰椎布鲁杆菌性脊柱炎疗效比较[J].新乡医学院学报,2016,33(1):048-50.[doi:10.7683/xxyxyxb.2016.01.014]
　HOU Wen-gen,LU Tan,ZHANG Chao,et al.Comparison of clinical effect of bone grafting fusion debridement alone，and combined with posterior pedicle screw fixation in the treatment of thoracolumbar Brucella spondylitis[J].Journal of Xinxiang Medical University,2016,33(1):048-50.[doi:10.7683/xxyxyxb.2016.01.014]
点击复制

单独病灶清除植骨融合与联合后路椎弓根螺钉内固定术治疗胸腰椎布鲁杆菌性脊柱炎疗效比较
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
33
期数:
2016年1
页码:
048-50
栏目:
临床研究
出版日期:
2016-01-05

文章信息/Info

Title:
Comparison of clinical effect of bone grafting fusion debridement alone，and combined with posterior pedicle screw fixation in the treatment of thoracolumbar Brucella spondylitis
作者:
侯文根; 路　坦; 张　超; 孙晓辉
（新乡医学院第一附属医院骨二科，河南　卫辉　453100）
Author(s):
HOU Wen-gen; LU Tan; ZHANG Chao; SUN Xiao-hui
（Department of the Second Osteology，the First Affiliated Hospital of Xinxiang Medical University，Weihui 453100，Henan Province，China）
关键词:
病灶清除植骨融合; 后路椎弓根螺钉内固定术; 胸椎; 腰椎; 布鲁杆菌性脊柱炎
Keywords:
debridement and fusion posterior pedicle screw fixation; thoracic vertebra; lumbar vertebra; Brucella spondylitis
分类号:
R681.5
DOI:
10.7683/xxyxyxb.2016.01.014
文献标志码:
A
摘要:
目的　比较单独病灶清除植骨融合与联合后路椎弓根螺钉内固定术治疗胸腰椎布鲁杆菌性脊柱炎的效果。方法　选择2012年4月至2014年4月在新乡医学院第一附属医院接受手术治疗的胸腰椎布鲁杆菌性脊柱炎患者78例，随机分为观察组和对照组，每组39例。观察组患者实施病灶清除、植骨融合及后路椎弓根螺钉内固定术，对照组患者单独予以病灶清除、植骨融合手术。随访6个月，比较2组患者的治疗效果、治疗前后神经功能Frankel分级及影像学评分，分析患者神经功能Frankel分级与影像学评分的相关性。结果　观察组患者治疗总有效率（89.74%）显著高于对照组（71.79%）（P<0.05）。治疗后观察组患者神经功能Frankel分级显著优于对照组（P<0.05）。治疗后2组患者影像学评分均有改善，但观察组患者1、3、6个月的影像学评分均显著高于对照组（P<0.05）。布鲁杆菌性脊柱炎患者的神经功能Frankel分级水平与影像学评分呈正相关（P<0.01）。结论　病灶清除植骨融合联合后路椎弓根螺钉内固定手术方案治疗布鲁杆菌性脊柱炎的疗效更佳，患者神经功能恢复更好。
Abstract:
Objective　To observe and compare the clinical effect of bone grafting fusion debridement alone，and combined with posterior pedicle screw fixation in the treatment of thoracolumbar Brucella spondylitis.Methods　A total of 78 cases of patients with thoracolumbar Brucella spondylitis who accepted operation treatment in the First Affiliated Hospital of Xinxiang Medical University from April 2012 to April 2014 were selected，and were randomly divided into observation group and control group with 39 cases in each group.The patients in observation group accepted debridement，interbody fusion and pedicle screw internal fixation through posterior approach operation treatment，while the patients in control group accepted debridement，bone graft fusion operation scheme only.After 6 months of follow-up，the clinical efficacy，nerve function Frankel grading and the imaging scores of the two groups before and after treatment were compared，and the correlation between Frankel classification and image score was analyzed.Results　The total effective rate of observation group（89.74%） was significantly higher than that of control group（71.79%）(P<0.05).After treatment，the Frankel classification of observation group was better than that of control group（P<0.05）.The radiographic score of the two groups after treatment improved than before treatment，which in observation group was significantly higher than that in control group at 1，3 and 6 months of treatment(P<0.05).Frankel classification had positive correlation relationship with the radiographic score（P<0.01）.Conclusion　Debridement and bone graft fusion，and pedicle screw internal fixation via posterior operation scheme for the treatment of patients with Brucella spondylitis had better curative effect and neurological function recovery.

参考文献/References:

［1］　于占水，程大伟，陈雪英，等.布鲁杆菌性脊柱炎临床特征及误诊分析［J］.中华地方病学杂志，2013，32(5)：559-561.
［2］　AKTUG-DEMIR N，KOLGELIER S，OZCIMEN S，et al.Diagnostic clues for spondylitis in acute brucellosis［J］.Saudi Med J，2014，35(8)：816-820.
［3］　侯居魁.布鲁氏杆菌性脊柱炎的螺旋CT与MR的影像表现［J］.中国实用医药，2014，9(4)：29-30.
［4］　LIM K B，KWAK Y G，KIM D Y，et al.Back pain secondary to Brucella spondylitis in the lumbar region［J］.Ann Rehabil Med，2012，36(2)：282-286.
［5］　董帅，白皓天，李媛冰，等.布鲁氏菌性脊柱炎的影像学表现及其治疗［J］.中国老年学杂志，2014，34(8)：2310-2312.
［6］　CANNELLA A P，LIN J C，LIANG L，et al.Serial kinetics of the antibody response against the complete Brucella melitensis ORFeome in focal vertebral brucellosis［J］.J Clin Microbiol，2012，50(3)：922-926.
［7］　BENEDETTO F，LENTINI S，PASSARI G，et al.Endovascular repair of aortic rupture due to Brucella aortitis［J］.Vasa，2011，40(2)：150-156.
［8］　费琦，杨雍，李锦军，等.布氏杆菌性脊柱炎致下肢不全截瘫1例并文献复习［J］.中国临床医生，2014，42(2)：48-50.
［9］　柴晓亮，吴晓燕，陆皓，等.高海拔地区布鲁杆菌性脊柱炎病人的护理［J］.护理研究，2014，28(11B)：4082-4083.
［10］　MALAISE O，LIBON F，BRICMAAN J，et al.Two spondylodiscitis due to a contamination by Brucella melitensis in a mother and daughter back from holidays［J］.Rev Med Suisse，2014，10(414)：197-200.
［11］　SANAEI-DASHTI A，KARIMI A.Skeletal involvement of Brucella melitensis in children：a systematic review［J］.Iran J Med Sci，2013，38(4)：286-292.

更新日期/Last Update: 2016-01-05