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)

Abstract:

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)