前后路联合入路治疗脊柱结核研究进展
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摘要
脊柱结核是一种常见的肺外结核,且其发病率近年呈不断上升趋势,目前随着对脊柱结核研究的不断深入,关于脊柱结核的治疗也以及衍生出了多种手术方式。而脊柱结核病灶清除的不彻底容易导致病情复发,手术失败,因而对于病灶彻底的清除,解除脊髓的神经的压迫,追求骨性愈合是当前脊柱结核手术治疗的最终目的。而前后路联合入路的手术方式能够相对较为彻底的清除结核病灶,达到满意的手术效果,现就脊柱结核前后路联合治疗的研究现状做简要概述。
Spinal tuberculosis is a common extrapulmonary tuberculosis, and its incidence has been on the rise in recent years.With the deepening of research on spinal tuberculosis, the treatment of spinal tuberculosis has also led to a variety of surgical methods.However, the incomplete removal of spinal tuberculosis lesions easily leads to recurrence of the disease, and the operation fails.Therefore, the complete removal of the lesions, the suppression of nerve compression of the spinal cord, and the pursuit of bone healing are the ultimate goals of current spinal tuberculosis surgery. The surgical approach of the anterior and posterior approach can relatively completely eliminate the tuberculosis lesions and achieve satisfactory surgical results. The current research status of the combined treatment of spinal tuberculosis before and after the road is briefly summarized.
Spinal tuberculosis is a common extrapulmonary tuberculosis, and its incidence has been on the rise in recent years.With the deepening of research on spinal tuberculosis, the treatment of spinal tuberculosis has also led to a variety of surgical methods.However, the incomplete removal of spinal tuberculosis lesions easily leads to recurrence of the disease, and the operation fails.Therefore, the complete removal of the lesions, the suppression of nerve compression of the spinal cord, and the pursuit of bone healing are the ultimate goals of current spinal tuberculosis surgery. The surgical approach of the anterior and posterior approach can relatively completely eliminate the tuberculosis lesions and achieve satisfactory surgical results. The current research status of the combined treatment of spinal tuberculosis before and after the road is briefly summarized.
引文
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[16]Jiaming Liu,Linyue Wan,Xinhua Long,et al.Comparison of clinical efficacy and safety among three surgical approaches for the treatment of spinal tuberculosis:a meta-analysis[J].Eur Spine J,2016,25(12).
[17]Zeng,H;Shen,XJ;Luo,CK;et al.360-degree cervical spinal arthrodesis for treatment of pediatric cervical spinal tuberculosis with kyphosis[J].BMCMUSCULOSKEL DIS,2016,17.
[18]Chen WJ,Wu CC,Jung CH,et al.Combined anterior and posterior surgeries in the treatment of spinal tuberculous spondylitis[J].Clin Orthop Relat Res,2002,398:50-9.
[19]曹友全.单纯后路及前后路联合治疗脊柱结核临床疗效对比[J].现代仪器与医疗,2017,23(04):105.
[20]何超.一期前路病灶清除植骨融合内固定与前后路联合治疗多发下胸椎结核的临床疗效比较[J].重庆医学,2015,44(14).
[21]Wen-Jer Chen.Combined Anterior and Posterior Surgeries in the Treatment of Spinal Tuberculous Spondylitis[J].INT ORTHOP,2015,39(8):1605-1610.
[22]Yuan Zheng Ma&Xu Cui.Outcomes of anterior and posterior instrumentation under different surgical procedures for treating thoracic and lumbar spinal tuberculosis in adults Received:20 June 2011/Accepted:6October 2011/Published online:30 October 2011#Springer-Verlag 2011.
[23]No effect of platelet-rich plasma with frozen or processed bone allograft around noncemented implants Springer-Verlag 2005[J].International Orthopaedics(SICOT)(2005)29:67-72.
[24]Christodoulou AG,Givissis P,Karataglis D,et al.Treatment of tuberculous spondylitis with anterior stabilization and titaniumcage[J].ClinOrthop,2006,444(444):60-65.
[25]高永建,欧云生,邓乾兴,等.钛笼与髂骨块植骨修复椎骨缺损治疗胸腰椎结核的疗效比较[J].中国矫形外科杂志,2017,25(5):404-409.
[26]Wang YX,Zhang HQ,Liao W,et al.One-stage posterior focus debridement,inter body graft using titanium mesh cages,posterior instrumentation and fusion in the surgical treatment of lumbo-sacral spinal tuberculosis in the aged[J].IntOrthop,2016,40(2):11171124.
[27]张宏其,尹新华,黎峰,等.脊柱结核手术治疗并发症及相关危险因素的探讨[J].中国矫形外科杂志,2014,22(1):20-27.
[28]Cui X,Ma YZ,Chen X,Cai XJ,Li HW,Bai YB.Outcomes of different surgical procedures in the treatment of spinal tuberculosis in adults[J].Med Princ Pract,2013,22(4):346-50.
[29]张宏其,王龙杰,唐明星,等.脓肿清除术联合置管小剂量灌洗处理胸腰椎结核术后复发的临床疗效[J].中国矫形外科杂志,2016,24(5):401-405
[2]Kaloostian PE,Gokaslan ZL.Current management of spinal tuberculosis:a multimodal approach.
[3]Jin D,Dongbin Qu,Chen J,et al.One-stage anterior interbody autografting and instrumentation in primary surgical management of thoracolumbar spinal tuberculosis[J].Eur Spine J,2004,13:114-121.
[4]Jin D,Dongbin Qu,Chen J,et al.One-stage anterior interbody autografting and instrumentation in primary surgical management of thoracolumbar spinal tuberculosis[J].Eur Spine J,2004,13:114-121.
[5]Benli,I T,M Kis,S Akalin,et al.The results of anterior radical debridement and anterior instrumentation in Pott’s disease and comparison with other surgical techniques[J].Kobe J Med Sci,2000,46,39-68.
[6]Wang X,Pang X,Wu P,et al.One-stage anterior debridement,bone grafting and posterior instrumentation vs.single posterior debridement,bone grafting,and instrumentation for the treatment of thoracic and lumbar spinal tuberculosis[J].Eur Spine J,2014,23(4):830-837.
[7]Liu P,Sun M,Li S,et al.A retrospective controlled study of three different operative approaches for the treatment of thoracic and lumbar spinal tuberculosis:three years of follow-up[J].Clin Neurol Neurosurg,2015,128:25-34.
[8]张伟,蔚芃,蒋成,等.一期前后联合入路治疗胸腰段脊柱结核[J].脊柱外科杂志,2013,11(3):160-163.
[9]沈晓飞,郭开今,赵凤朝,等.一期前后联合入路手术治疗活动性脊柱结核[J].南京医科大学学报(自然科学版),2014,1007-4368.
[10]瞿东滨,金大地,陈建庭,等.脊柱结核外科治疗的术式选择[J].中华骨科杂志,2005,25(2):74-78.
[11]郭强,张宏其.单纯经后路病灶清除椎体间植骨术治疗脊柱结核的研究进展[J].中国矫形外科杂志,2018,26(02):150-155.
[12]Nottmeier EW,Deen HG,Patel N,Birch B.Cervical kyphotic deformity correction using 360-degree reconstruction[J].J Spinal Disord Tech.,2009,22(6):385-91.
[13]Nottmeier EW,Deen HG,Patel N,Birch B.Cervical kyphotic deformity correction using 360-degree reconstruction[J].J Spinal Disord Tech,2009,22(6):385-91.
[14]胡杰挺,陈建生,钱钟,等.三种不同手术入路治疗脊柱结核疗效对比分析[J].浙江创伤外科,2015,20(2).
[15]武学才,向少华,申财芳,一期前后路联合手术治疗腰骶段脊柱结核的临床观察[J].临床合理用药,2014,7(1A).
[16]Jiaming Liu,Linyue Wan,Xinhua Long,et al.Comparison of clinical efficacy and safety among three surgical approaches for the treatment of spinal tuberculosis:a meta-analysis[J].Eur Spine J,2016,25(12).
[17]Zeng,H;Shen,XJ;Luo,CK;et al.360-degree cervical spinal arthrodesis for treatment of pediatric cervical spinal tuberculosis with kyphosis[J].BMCMUSCULOSKEL DIS,2016,17.
[18]Chen WJ,Wu CC,Jung CH,et al.Combined anterior and posterior surgeries in the treatment of spinal tuberculous spondylitis[J].Clin Orthop Relat Res,2002,398:50-9.
[19]曹友全.单纯后路及前后路联合治疗脊柱结核临床疗效对比[J].现代仪器与医疗,2017,23(04):105.
[20]何超.一期前路病灶清除植骨融合内固定与前后路联合治疗多发下胸椎结核的临床疗效比较[J].重庆医学,2015,44(14).
[21]Wen-Jer Chen.Combined Anterior and Posterior Surgeries in the Treatment of Spinal Tuberculous Spondylitis[J].INT ORTHOP,2015,39(8):1605-1610.
[22]Yuan Zheng Ma&Xu Cui.Outcomes of anterior and posterior instrumentation under different surgical procedures for treating thoracic and lumbar spinal tuberculosis in adults Received:20 June 2011/Accepted:6October 2011/Published online:30 October 2011#Springer-Verlag 2011.
[23]No effect of platelet-rich plasma with frozen or processed bone allograft around noncemented implants Springer-Verlag 2005[J].International Orthopaedics(SICOT)(2005)29:67-72.
[24]Christodoulou AG,Givissis P,Karataglis D,et al.Treatment of tuberculous spondylitis with anterior stabilization and titaniumcage[J].ClinOrthop,2006,444(444):60-65.
[25]高永建,欧云生,邓乾兴,等.钛笼与髂骨块植骨修复椎骨缺损治疗胸腰椎结核的疗效比较[J].中国矫形外科杂志,2017,25(5):404-409.
[26]Wang YX,Zhang HQ,Liao W,et al.One-stage posterior focus debridement,inter body graft using titanium mesh cages,posterior instrumentation and fusion in the surgical treatment of lumbo-sacral spinal tuberculosis in the aged[J].IntOrthop,2016,40(2):11171124.
[27]张宏其,尹新华,黎峰,等.脊柱结核手术治疗并发症及相关危险因素的探讨[J].中国矫形外科杂志,2014,22(1):20-27.
[28]Cui X,Ma YZ,Chen X,Cai XJ,Li HW,Bai YB.Outcomes of different surgical procedures in the treatment of spinal tuberculosis in adults[J].Med Princ Pract,2013,22(4):346-50.
[29]张宏其,王龙杰,唐明星,等.脓肿清除术联合置管小剂量灌洗处理胸腰椎结核术后复发的临床疗效[J].中国矫形外科杂志,2016,24(5):401-405