One stage posterior lumbar radical debridement combined with disease of vertebral nailing and posterior short-segment pedicle internal fixation, and bone grafting on single gap brucellar spondylitis of the lumbar vertebrae
Hu Changbo, Yang Xinming
Department of Orthopaedics, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
Abstract：Objective To evaluate the feasibility and efficacy of the treatment on single-lumbar brucellosis spondylitis with a short-segment fixation of the posterior pedicle screw fixation and the removal of the intervertebral bone graft.Methods From January 2015 to January 2016, the clinical data of 27 patients with lumbar spondylitis in the First Affiliated Hospital of Hebei North University were retrospectively analyzed. Fifteen males and 12 females, aged from 42 to 65 years, mean 55.2 years. All patients were single-gap lesions involving two vertebral bodies. Among them, L1-2 1 patient, L2-3 3 patients, L3-4 8 patients, L4-5 2 patients, L5-S1 3 patients, 27 patients were combined with varying degrees of neurological impairment, and were given at least a course of regular drug treatment before operation. Twenty-seven patients with surgical indications of lumbar brucellosis spondylitis patients with a posterior pediatric stapler stent fixation plus lesion removal of intervertebral bone graft surgery. Preoperative, postoperative and follow-up were examined by Cobb angle, visual analogue scale (VAS), American Spinal Injury Association (ASIA) rating of spinal cord function recovery, laboratory test erythrocyte sedimentation rate Erythrocyte sedimentation rate (ESR), C reactive protein (CRP), rose bengal plate agglutination test (RBPT) and X-ray, CT and MRI,and “cure, improvement and ineffective” used as clinical evaluation criteria.Results Twenty-seven cases were followed up from 12 to 25 months, an average of 18 months, no sinus formation and recurrence. The mean Cobb angle was 14.89°±1.48° at preoperation, 4.00°±1.44° at 3 months postoperatively, 4.01°±0.87°at 6 months postoperatively, and VAS scores were (8.4±1.6) points, (3.1±0.3) points, (1.1±0.3) points and (0.7 ± 0.2) points 3, 6 and 12 months postoperatively, respectively. The postoperative time of all the patients was significantly improved (all P values<0.05).After the operation ,the ESR, CRP and Cobb angle were reduced evidently over time, the differences were statistically significant (all P values<0.01). The negative rate (normal rate) of the RBPT was 48.14% at 3 months postoperatively, and 100% at 6 months postoperatively.Clinical curative effect evaluation: with postoperative time, cure rate increased gradually, 3, 6, 12 months the cure rate was 59.25% (16 patients cured, 10 patients were improved and 1 patient had no effect), 81.48%(22 patients cured, improved in 5 patients), 96.29% (cure 26 patients, improvement in 1 patient) when cure rate before a time point was compared with that after a time point, the difference was statistically significant (all P values<0.05).Conclusions There is feasibility and efficacy on the treatment of single-lumbar brucellosis spondylitis with a short-segment fixation of the posterior pedicle screw fixation and the removal of the intervertebral bone graft under the application of effective control of the drug. It has obvious advantages in relieving pain, stabilizing spine and restoring nerve function.
胡长波, 杨新明. 一期后路病灶清除病椎置钉短节段内固定加椎间或关节突间植骨治疗单间隙腰椎布鲁杆菌病性脊柱炎[J]. 中华解剖与临床杂志, 2018, 23(2): 110-116.
Hu Changbo, Yang Xinming. One stage posterior lumbar radical debridement combined with disease of vertebral nailing and posterior short-segment pedicle internal fixation, and bone grafting on single gap brucellar spondylitis of the lumbar vertebrae. Chinese Journal of Anatomy and Clinics, 2018, 23(2): 110-116.
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2018, Vol. 23 
