Email Alert | RSS    帮助

中国防痨杂志 ›› 2019, Vol. 41 ›› Issue (3): 277-282.doi: 10.3969/j.issn.1000-6621.2019.03.007

所属专题: 骨关节结核外科治疗专题

• 论著 • 上一篇    下一篇



  1. 830054 乌鲁木齐,新疆医科大学第一附属医院脊柱外科
  • 收稿日期:2018-07-20 出版日期:2019-03-10 发布日期:2019-03-15
  • 通信作者: 郭海龙

Curative effect analysis of single-stage anterior debridement and internal fixation for cervical spine osteomyelitis

Wei-ping LI,Chuan-hui XUN,Hao GUO,Rui CAO,Wei-bin SHENG,Hai-long GUO()   

  1. Department of Spinal Surgery,the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
  • Received:2018-07-20 Online:2019-03-10 Published:2019-03-15
  • Contact: Hai-long GUO


目的 评估一期前路病灶清除植骨内固定术治疗颈椎感染的临床疗效。方法 搜集2010年6月至2016年6月新疆医科大学第一附属医院行一期前路病灶清除植骨内固定术治疗的58例颈椎感染患者,其中化脓性颈椎感染10例,结核性颈椎感染35例,布鲁杆菌颈椎感染7例,不明原因颈椎感染6例。男36例,女22例;年龄17~79岁,平均(62.7±12.4)岁。术后采用Eck植骨融合和标准评价植骨融合情况,临床疗效评价采用视觉模拟评分(VAS)、日本骨科协会(JOA)评分(颈椎)。 术后随访时间13~32个月,平均(24.9±6.4)个月。采用SPSS 23.0软件分析,计量资料采用“$\bar{x}$±s”表示,术前与末次随访时的数据比较采用配对t检验, 以P<0.05为差异有统计学意义。结果 术后患者临床症状均明显缓解,颈部VAS评分术前平均为(5.3±0.8)分,术后1个月为(2.3±0.8)分,术后6个月为(0.9±0.5)分,末次随访为(0.6±0.5)分,术前与术后末次随访VAS评分比较,差异有统计学意义(Z=-6.75,P=0.00)。术前JOA评分平均为(11.0±0.9)分,术后1个月为(13.6±1.0)分,术后6个月为(15.6±1.0)分,末次随访为(15.9±0.8)分;术前与术后末次随访JOA评分比较差异有统计学意义(t=-51.10, P=0.00)。36例患者术后1年随访时植骨融合手术节段基本达到Ⅰ级融合。术后有5例患者出现声嘶,给予口服营养神经药物,随访观察1个月后痊愈。2例化脓性颈椎感染患者术后2周内出现切口感染,经再次清创后痊愈。随访期间本组患者均未产生内固定松动、断裂等现象。结论 一期前路病灶清除植骨内固定治疗颈椎感染可彻底清除病灶、解除神经压迫,疗效确切,是一种良好的治疗方法。

关键词: 颈椎, 骨疾病, 感染性, 外科手术, 选择性, 随访研究, 结果评价(卫生保健)


Objective To evaluate the clinical effect of treatment of cervical spine osteomyelitis via single-stage anterior debridement and bone graft fusion.Methods A retrospective information of 58 cases (male 36 cases, female 22 cases,) with cervical spine osteomyelitis treated by single-stage anterior debridement and bone graft fusion from June 2010 to June 2016 was collected. The mean age of these patients was 62.7±12.4 years (range 17-79 years). There were 10 cases of suppurative cervical spondylosis, 35 cases of tuberculous cervical spondylosis, 7 cases of Brucella cervical spondylosis and 6 cases of cervical spondylosis of unknown origin. The disease controlling statues was evaluated based on laboratory result of erythrocyte sedimentation rate and C-reactive protein. Eck fusion and grading criteria were taken to evaluate the fusion of vertebral body. The clinical effects were evaluated using the Visual Analogue Scale (VAS) and the Japanese Orthopedic Association score (Cervical) of cervical function. The data were analyzed by SPSS 23.0 statistical software. The measurement data were expressed by ($\bar{x}$±s). The data of preoperative and last follow-up were compared by paired t test. P<0.05 was statistically significant.Results All of 58 cases of patients’ symptom were significantly improved. The cervical VAS score: average (5.3±0.8)points before operation, average (2.3±0.8)points,(0.9±0.5)points,(0.6±0.5)points in one month、 six months after operation and the last time follow up, respectively.The postoperative VAS score was significantly lower than that before operation(Z=-6.75, P=0.00), The JOA score: average (11.0±0.9)points before operation, average (13.6±1.0)points,(15.6±1.0)points,(15.9±0.8)points in one month、 six months after operation and the last time follow up, respectively. The postoperative JOA score was significantly lower than that before operation (t=-51.10,P=0.00). All patients were not found internal fixation loosening and fracture in the follow-up period. 5 patients had hoarseness after operation, follow-up observation after a month of recovery. 2 patients with pyogenic infectious occurred wound infection two weeks after operation and recovery by re-debridement. Conclusion Cervical spine osteomyelitis treated by single-stage anterior debridement and bone graft fusion had a definite curative effect which can completely remove the lesionand remove the nerve compression.

Key words: Cervical vertebrae, Bone diseases, infectious, Surgical procedures, elective, Follow-up studies, Outcome assessment (health care)