[1]赵涛,高腾飞△,方海林,等.腹膜后一期前路单节段病灶清除植骨内固定术治疗老年L4～5椎体结核临床疗效研究[J].陕西医学杂志,2019,(1):86-88.
　ZHAO Tao,GAO Tengfei,FANG Hailin,et al.Clinical efficacy of onestage anterior retroperitoneal singlesegment debridement and bone grafting for the treatment of senile L4～5 vertebral tuberculosis〖WT4”BZ〗[J].,2019,(1):86-88.
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腹膜后一期前路单节段病灶清除植骨内固定术治疗老年L4～5椎体结核临床疗效研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年1期
页码:
86-88
栏目:
临床研究
出版日期:
2019-01-05

文章信息/Info

Title:
Clinical efficacy of onestage anterior retroperitoneal singlesegment debridement and bone grafting for the treatment of senile L4～5 vertebral tuberculosis〖WT4”BZ〗
文章编号:
DOI:10.3969/j.issn.10007377.2019.01.027
作者:
赵涛; 高腾飞△; 方海林; 彭茂轩
陕西省结核病防治院（陕西省第五人民医院）（西安710100）
Author(s):
ZHAO Tao ; GAO Tengfei ; FANG Hailin ; et al.
Shaanxi Province Tuberculosis Prevention and Treatment Institute The Fifth People’s Hospital of Shaanxi Province（Xi’an 710100）
关键词:
下腰椎; 椎体结核; 前路手术; 病灶清除; 植骨; 内固定; 老年人
Keywords:
Key words Lower lumbar spine; Vertebral tuberculosis; Anterior surgery; Removal of lesions;  Bone grafting; Internal fixation; Aged
分类号:
R681.5
文献标志码:
A
摘要:
摘 要 目的：探讨经腹膜后一期前路单节段病灶清除植骨内固定术治疗L4～5椎体结核的临床疗效。方法：选择年龄大于65岁，需行手术治疗的L4～5椎体结核患者18例，全部采用经腹膜后前路病灶清除、植骨、钢板螺钉内固定术治疗。结果：18例患者切口均一期愈合，手术时间110～190 min，平均（150.35±25.81）min；术中出血量400～900 ml，平均（600.32±56.92）ml；术后植骨均达到骨性融合，融合时间4～7个月，平均6个月；术后随访6～36个月，平均24个月；随访期无死亡及严重并发症发生。至末次随访，Cobb角术后无明显丢失，腰背部疼痛、下肢放射痛、麻木症状完全消失；神经功能均有不同程度恢复，Frankel分级，A级0例，B级0例，C级1例，D级6例，E级11例。无内固定松动及断裂现象。植骨块无滑脱、假关节形成；结核无复发。结论：经腹膜后手术治疗L4～5椎体结核对于年老体弱的患者手术时间短、创伤小、出血量少、疗效确切，安全性高。
Abstract:
AbstractObjective: To investigate the clinical efficacy of retroperitoneal anterior approach for L4～5 vertebral tuberculosis.Methods: 18 patients with L4～5 vertebral tuberculosis who were treated with surgery for more than 65 years old. All of them were treated with transperitoneal anterior debridement and bone grafting，plate screw internal fixation.Results: All the 18 patients underwent onestage incision. The operation time was 110～190 min, with an average of （150.35±25.81） min. The intraoperative blood loss was 400～900 ml, with an average of（600.32±56.92） ml. The postoperative bone grafts reached bony fusion. The fusion time was 4～7 months, with an average of 6 Months, followed up for 6～36 months, an average of 24 months；no deaths and serious complications occurred during followup. At the last followup, there was no significant loss of cobb angle, and the pain in the lower back, radiation pain in the lower extremities, and numbness disappeared completely. Neurological function has different degrees of recovery, Frankel classification, 0 cases of grade A, 0 cases of grade B, 1 case of grade C, 6 cases of grade D, 11 cases of grade E. No internal fixation loose and broken. There is no slippage and pseudoarticular formation in the bone graft; there is no recurrence of tuberculosis.Conclusion: Treatment of L4～5 vertebral tuberculosis by retroperitoneal surgery for elderly and frail patients with short operation time, less trauma, less bleeding, effective curative effect and high safety. Recommended.

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更新日期/Last Update: 2019-01-22