一期后路手术治疗合并硬膜外脓肿的腰椎布鲁氏菌脊柱炎

目的总结一期后路手术治疗合并硬膜外脓肿的腰椎布鲁氏菌脊柱炎的临床疗效。 方法选择2014年1月至2018年12月应用一期后路手术治疗腰椎布鲁氏菌脊柱炎伴硬膜外脓肿23例，在规范抗布鲁氏菌病基础上，采用后路病灶清除、椎板减压、短节段固定及椎间植骨融合方法进行治疗。观察患者术后腰腿痛减轻及植骨融合情况。 结果术后23例均获随访，随访时间平均（16.28±3.26）个月，术后切口均一期愈合，布鲁氏菌病的症状消失，内固定牢固，植骨融合时间（7.42±1.26）个月。按Nakano等提出的腰背痛手术疗效标准：优，16例；良，5例；可，2例。 结论对合并硬膜外脓肿的腰椎布鲁氏菌脊柱炎在规范抗感染治疗的基础上，行一期后路病灶清除、短节段固定及植骨融合可取得较满意的效果。

One-stage posterior surgery for treatment of lumbar brucellar spondylitis with epidural abscess

ObjectiveTo assess the safety and efficacy of one-stage posterior surgery in the treatment of lumbar brucellar spondylitis with epidural abscess. MethodsA retrospective analysis was performed on 23 cases of lumbar brucellar spondylitis patients who were treated by one-stage posterior radical debridement, lamina decompression, short segment internal fixation, and intervertebral fusion from January 2014 to December 2018. ResultsThe 23 patients were followed for an average period of (16.28±3.26) months. All the incisions achieved primary healing. There was no loss, breakage, or loosening of internal fixation. The brucellosis spondylitis symptoms disappeared in all patients. According to the operative efficacy criteria proposed by Nakano et al for low back pain, the results were excellent in 16 cases, good in 5 cases, and fair in 2 cases. The bone graft fusion time was (7.42±1.26) months. ConclusionOn the basis of standard anti-brucellosis chemotherapy, one-stage clearance of lesions, posterior debridement, short segment of internal fixation, and intervertebral fusion are a safe and effective surgical method for lumbar brucellar spondylitis with epidural abscess.