腹膜后腔镜辅助下小切口结核病灶清除、植骨融合术治疗腰椎结核疗效分析-外科学(骨外科)专业论文.docxVIP

福建医科大学 福建医科大学 2013 年硕士学位论文 PAGE PAGE 10 Retroperitoneal laparoscopic-assisted small incision for lumbar spine tulbercullosis ABSTRACT Objective: Explore the retroperitoneal laparoscopic-assisted small incision for lumbar spine tulbercullosis spinal tuberculosis treatment. Methods: Rtrospective analysis was conducted from January 2006 - January 2012 during the treatment of lumbar pinal tuberculosis, which employs retroperitoneal laparoscopic-assisted small incision tuberculosis clearance, bone grafting treatment of spinal tuberculosis patients were followed for complete information on 12 cases. 9 males and 3 females; aged 20-74 years, mean 46.83 years old. Lesion segments: L1-L2 2 cases, L2-L3 5 cases, L3-L4 4 cases, L4-L5 1 cases Neurologically impaired four cases, ASIA grade C 1 case, D grade 3 cases. Preoperative X-ray CT and MRI diagnosis of spinal tuberculosis, postoperative pathological examination. Preoperative and postoperative neurological function based on neurological function. Continuing anti-TB treatment in 9 to 12 months. Press after one month, three months, six months, one year, two year follow-up laboratory tests and imaging findings. Results: 12-48 month follow-up, mean 24.14 ± 9.65 months. The mean operative time 2.90 ± 0.50 h, mean blood 260.52 ± 54.96 ml, no intraoperative complications. 4 cases of preoperative patients neurologically impaired nerve function returned to normal, ASIA classification are E-Class. The average preoperative Cobb angle was (20.21 ± 6.18) °, mean postoperative Cobb angle was (11.43 ± 4.20) °, correction of kyphosis case P 0.01, statistically significant, the average angle of final follow-up loss (2.73 ± 1.82) °. After 6 months, bony fusion rate was 60% at 2 years fusion of 100%. All last follow-up showed no recurrence of tuberculosis. Conclusion: Laroscopic retmperitoneal approach is safe and reliable for lumbar spine tuberculosis． Keywords： lumbar spinal tuberculosis, laparoscopy ，retroperitoneal space，small incision