Clinical Characteristics and Prevention Strategies of Surgical Site Infection After Percutaneous Endoscopic Lumbar Discectomy
10.3969/j.issn.1009-6604.2024.05.005
- VernacularTitle:经皮脊柱内镜腰椎间盘摘除术后手术部位感染的临床特点及防治策略
- Author:
Rongbin CHEN
1
;
Yizhi PAN
;
Wenchuang CHEN
;
Yao LU
;
Jinxin ZHANG
;
Zhaodian WU
;
Yong LI
Author Information
1. 广东省中医院珠海医院骨三科,珠海 519015
- Keywords:
Percutaneous endoscopic lumbar discectomy;
Lumbar disc herniation;
Surgical site infection;
Clinical characteristics;
Prevention strategy
- From:
Chinese Journal of Minimally Invasive Surgery
2024;24(5):343-349
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the diagnosis and treatment experience of surgical site infection(SSI)after percutaneous endoscopic lumbar discectomy(PELD).Methods A retrospective analysis was made on 11 cases of postoperative SSI after PELD from January 2016 to December 2022.After PELD surgery,severe lower back or lower limb pain occurred in all the patients,with a Visual Analog Scale(VAS)score of 7-9(average,8.1).The erythrocyte sedimentation rate(ESR)was 17-114 mm/h(average,54.4 mm/h),and the level of C-reactive protein(CRP)was 8-151 mg/L(average,56.5 mg/L).The MRI showed changes of inflammatory signals in the intervertebral space of the surgical area.The SSI was diagnosed at 2-17 d(average,9.5 d)after PELD surgery.All the cases were treated with antibiotics(4 cases with empiric antibiotic therapy and 7 cases with sensitive antibiotic treatment),8 of which underwent combined surgery,including percutaneous endoscopic lesion removal,catheter irrigation and drainage in 4 cases,posterior lesion removal in 2 cases,and posterior lesion removal combined with internal fixation in 2 cases.Results The patients were followed up for 14-75 months(average,36.8 months).According to the modified MacNab criteria,5 cases were excellent,4 cases were good,and 2 cases were fair.Conclusions SSI after PELD is characterized by acute onset,recurrent severe lower back or lower limb pain,elevated inflammatory markers,and characteristic imaging features.Standardized antibiotic treatment combined with surgery can achieve good therapeutic effects.
