目的 对比分析单纯后路内固定+一期经腰椎间孔病椎间病灶清除(TLIF)与经典的前后联合手术在布氏杆菌性脊柱炎患者中的临床疗效及安全性。 方法 对我院2015年1月至2017年12月收治的93例布病性脊柱炎患者的临床资料进行分析。按手术方式分为观察组(45例)和对照组(48例)。对两组患者的基础数据、临床指标、术前术后各项指标水平以及术后并发症、植骨治愈情况。 结果 观察组与对照组基础数据比较,差异无统计学意义(P>0.05)。观察组患者的手术时间、住院天数、术中出血量及术后下床时间均明显低于对照组(P<0.01)。两组患者术后3个月的ODI、VAS、CRP、ESR及Cobb角均明显低于术前(P<0.05)；术后3个月,观察组患者的ODI、VAS、CRP、ESR及Cobb角均明显低于对照组(P<0.05)。观察组术后并发症发生率(4.4%)明显低于对照组(25.0%)(Χ²=7.674,P<0.01)。 结论 TLIF治疗布氏杆菌性脊柱炎患者的临床疗效突出,安全性较好,更有利于患者术后身体的恢复。

Objective To compare and analyze the clinical efficacy and safety of thoracolumbar single segment of brucella spondylitis pedicle screw fixation (TLIF) and the traditional joint back and forth surgery in the patients with brucella spondylitis. Methods Clinical data of 93 patients with brucella spondylitis received treatment at our hospital from January, 2017 to December, 2017 was retrospectively analyzed. Patients included were divided into two groups according to the treatment, observe group (TLIF surgery, 45 cases) and control group (the traditional joint back and forth surgery, 48 cases). The general information, the clinical factors, the levels of the indexes before and after treatment, the adverse reactions and bone grafting after treatment in two groups were compared. Results The general information in two groups had no statistical difference (P>0.05). The operation time, the length of stay, the amount of intraoperative bleeding and the time after operation in observe group were obviously lower than those in control group (P<0.05).The values of ODI, VAS, CRP, ESR and Cobb in two groups after treatment were obviously lower than those before treatment (P<0.05). After 3 months of operation, the values of ODI, VAS, CRP, ESR and Cobb in two groups in observe group were obviously lower than those in control group (P<0.05). The adverse reactions rate in observe group (4.4%) was obviously lower than that in control group (25.0%) (Χ²=7.674,P<0.01). Conclusion The clinical efficacy of TLIF in treating the patients with brucella spondylitis is obvious, and the safety is better, which is better for the recovery of the patient.

R681.5