前后路联合自体三皮质髂骨和肋骨骨移植治疗胸椎结核严重后凸畸形的回顾性评价。

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-01-10 DOI:10.1016/j.neuchi.2025.101635

Shiwei Xie , Mingwei Luo , Gengwu Li , Heng Xiao

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引用次数: 0

摘要

背景：脊柱结核是脊柱畸形和神经功能障碍的常见原因，严重者手术治疗至关重要。本研究评价前后路手术联合自体三皮质髂骨和肋骨移植治疗脊柱结核的疗效和安全性。方法：我们纳入了61例胸椎结核患者，他们接受了外科手术，包括最初的后路矫正，随后是前路清创和自体三皮质髂骨和肋骨移植重建。通过术前和最终随访视觉类比量表（VAS）评分、后凸Cobb角、ASIA评分和影像学评价评估手术结果。记录围手术期并发症。结果：术前VAS评分为6.65±1.06，最终随访时VAS评分为2.63±0.94 (P)。结论：前后路联合自体髂三皮质骨肋骨植骨是治疗脊柱结核的有效方法，能显著减轻疼痛、矫正畸形、改善神经功能、促进骨融合。

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Retrospective evaluation of combined anterior and posterior surgery with autologous tricortical iliac and rib bone grafting for severe kyphotic deformity in thoracic spinal tuberculosis

Background

Spinal tuberculosis is a common cause of spinal deformity and neurological dysfunction, with surgical treatment being crucial in severe cases. This study evaluates the efficacy and safety of combined anterior and posterior surgery with autologous tricortical iliac bone and rib grafting for treating spinal tuberculosis.

Methods

We included 61 patients with thoracic tuberculosis, who underwent a surgical procedure involving initial posterior correction, followed by anterior debridement and reconstruction with autologous tricortical iliac bone and rib grafts. The surgical outcomes were assessed using preoperative and final follow-up visual analogy scale (VAS) scores, kyphotic Cobb angle, ASIA scores, and radiographic evaluations. Perioperative complications were recorded.

Results

Preoperative VAS scores were 6.65 ± 1.06, significantly decreasing to 2.63 ± 0.94 at the final follow-up (P < 0.001). The kyphotic Cobb angle improved from 26.28° ± 4.45° preoperatively to 12.05° ± 2.02° at the final follow-up (P < 0.001). Neurological function improved, with ASIA grade E increasing from 56 patients preoperatively to 59 at follow-up, and all patients achieved bony fusion at the final follow-up. The incidence of perioperative complications was 13.11%, primarily including deep vein thrombosis, superficial wound infections, and urinary tract infections, all of which resolved with symptomatic treatment.

Conclusions

Combined anterior and posterior surgery with autologous tricortical iliac bone and rib grafting is an effective method for treating spinal tuberculosis, significantly alleviating pain, correcting deformity, improving neurological function, and promoting bony fusion.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.