One-stage posterior debridement and spinal internal fixation for the treatment of lumbar Brucellar spondylitis
10.12200/j.issn.1003-0034.20230255
- VernacularTitle:Ⅰ期经后路病灶清除脊柱内固定术治疗腰椎布鲁菌病性脊柱炎
- Author:
Xian-Shuai KOU
1
;
Wei SHE
;
Gui-Fu MA
;
Xing-Yu PU
;
Yun-Biao WU
;
Yang QI
;
Wen-Yuan LUO
Author Information
1. 甘肃中医药大学第一临床医学院甘肃省人民医院,甘肃 兰州 730000
- Keywords:
Lumbar vertebrae;
Brucellosis;
Debridement;
Spinal internal fixation
- From:
China Journal of Orthopaedics and Traumatology
2024;37(8):764-771
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical efficacy and safety of one-stage posterior lesion removal and internal spinal fixation in patients with lumbar Brucellosis spondylitis.Methods The clinical data of 24 patients admitted from October 2017 to October 2022 were retrospectively analyzed,2 patients were lost to follow-up at 10 months after surgery,at the final 22 cases were included in the study,including 13 males and 9 females with an average age of(52.00±6.89)years old,were treated with one-stage posterior lesion removal and internal spinal fixation.The operation time,intraoperative bleeding,follow-up time,ery-throcyte sedimentation rate(ESR)and C-reactive protein(CRP)before and after operation were recorded.The pain visual ana-logue scale(VAS),Oswestry disability index(ODI),the Japanese Orthopaedic Association(JOA)score for neurofunction,American Spinal Injury Association(ASIA)spinal cord injury grade and modified MacNab criteria were ussed to evaluate the efficacy.Results All patients were followed up from 12 to 30 months with an average of(17.41±4.45)months.The operation time was 70 to 155 min with an average of(1 16.59±24.32)min;the intraoperative bleeding volume was 120 to 520 ml with an average of(275.00±97.53)ml.CRP and ESR levels decreased more significantly at 1 week and at the final follow-up than pre-operative levels(P＜0.05).VAS,JOA score and ODI at 1 week and at the latest follow-up were more significantly improved than preoperative results(P＜0.05).There was no significant difference between ASIA preoperative and 1 week after operation(P＞0.05),and a significant difference between preoperative and last follow-up(P＜0.05).In the final follow-up,21 patients had ex-cellent efficacy,1 patient had fair,and there was no recurrence during the follow-up.Conclusion One-stage transpedicular le-sion removal and internal spinal fixation,with few incisions and short operation time,helps the recovery of neurological func-tion,and the prognosis meets the clinical requirements,which can effectively control Brucella spondylitis.
