Uniportal endoscopic decompression and debridement for infectious diseases of spine with neurological deficits: a retrospective study in China
- Author:
Hui LV
1
;
Jianhong ZHOU
;
Yuan GUO
;
Sheng LIAO
;
Hui CHEN
;
Fei LUO
;
Jianzhong XU
;
Zhongrong ZHANG
;
Zehua ZHANG
Author Information
- Publication Type:Clinical Study
- From:Asian Spine Journal 2025;19(2):205-216
- CountryRepublic of Korea
- Language:English
-
Abstract:
Methods:This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed.
Results:Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05).
Conclusions:UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.
