Single-level lumbar pyogenic spondylodiscitis treated with minimally invasive anterior debridement and fusion combined with posterior fixation via Wiltse approach.
10.1007/s11596-013-1184-x
- Author:
Yang LIN
1
;
Wen-Jian CHEN
1
;
Wen-Tao ZHU
1
;
Feng LI
1
;
Huang FANG
1
;
An-Min CHEN
1
;
Wei XIONG
2
Author Information
1. Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
2. Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. xcxgreatwellus@hotmail.com.
- Publication Type:Journal Article
- MeSH:
Adult;
Aged;
Back Pain;
complications;
prevention & control;
Bacterial Infections;
complications;
microbiology;
Constipation;
etiology;
Debridement;
adverse effects;
methods;
Disability Evaluation;
Discitis;
complications;
surgery;
Escherichia coli;
isolation & purification;
Female;
Follow-Up Studies;
Humans;
Lumbar Vertebrae;
microbiology;
surgery;
Male;
Middle Aged;
Minimally Invasive Surgical Procedures;
adverse effects;
methods;
Pain Measurement;
Retrospective Studies;
Spinal Fusion;
adverse effects;
methods;
Staphylococcus aureus;
isolation & purification;
Staphylococcus epidermidis;
isolation & purification;
Streptococcus;
isolation & purification;
Treatment Outcome;
Urinary Retention;
etiology;
Venous Thrombosis;
etiology
- From:
Journal of Huazhong University of Science and Technology (Medical Sciences)
2013;33(5):707-712
- CountryChina
- Language:English
-
Abstract:
The effect and safety of anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach were assessed in the single-level lumbar pyogenic spondylodiscitis. Seventeen patients from 2007 to 2009 underwent anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach. Postoperative follow-up time was 24-41 months. Data included the patients' general information, microbiology, operative time, intraoperative blood loss, postoperative complications, intervertebral fusion rate, and preoperative and final follow-up scores for American Spinal Injury Association (ASIA) impairment, visual analogue scale (VAS), and Oswestry Disability Index (ODI). Ten patients had undergone a prior spinal invasive procedure, and 7 had hematogenous infection. The infected segments included L1-2, L2-3, L3-4, and L4-5 in 1, 2, 5, and 9 cases, respectively. Thirteen bacterial cultures were positive for Staphylococcus aureus (5 cases), Staphylococcus epidermidis (4), Streptococcus (3), and Escherichia coli (1). The operative time was 213.8±45.6 min, and the intraoperative blood loss was 180.6±88.1 mL. Postoperative complications consisted of urinary retention (2 cases), constipation (3), and deep vein thrombosis (2). On the final follow-up, VAS scores and ODIs were significantly lower than those of preoperation, while the ASIA grades improved. All the cases achieved good intervertebral bony fusion. Anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach can successfully treat single-level lumbar pyogenic spondylodiscitis, with less trauma and reliable immobilization. It is a viable option for clinical application.
