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Unilateral percutaneous endoscopic debridement and drainage for lumbar infectious spondylitis
BACKGROUND: The treatment of lumbar infectious spondylitis is controversial. In this study, we attempted to demonstrate that unilateral percutaneous endoscopic debridement with physiologic saline and negative pressure drainage postoperatively may achieve a satisfactory result in lumbar infectious sp...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276136/ https://www.ncbi.nlm.nih.gov/pubmed/30509282 http://dx.doi.org/10.1186/s13018-018-1009-5 |
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author | Wang, Xuepeng Zhou, Shaobo Bian, Zhenyu Li, Maoqiang Jiang, Wu Hou, Changju Zhu, Liulong |
author_facet | Wang, Xuepeng Zhou, Shaobo Bian, Zhenyu Li, Maoqiang Jiang, Wu Hou, Changju Zhu, Liulong |
author_sort | Wang, Xuepeng |
collection | PubMed |
description | BACKGROUND: The treatment of lumbar infectious spondylitis is controversial. In this study, we attempted to demonstrate that unilateral percutaneous endoscopic debridement with physiologic saline and negative pressure drainage postoperatively may achieve a satisfactory result in lumbar infectious spondylitis. METHODS: We retrospectively analyzed 17 patients with lumbar infectious spondylitis who underwent percutaneous endoscopic debridement and drainage (PEDD) through a posterolateral transforaminal approach. Each biopsy specimen was submitted without delay after surgery and examined for microorganisms and evaluated histopathologically. Patients were assessed by careful physical examination, MacNab criteria, Oswestry Disability Index (ODI), visual analog scale (VAS), regular serological tests, imaging studies for clinical function, and patient satisfaction. RESULTS: Of the 17 patients, 14 (82.4%) had satisfactory relief of their back pain according to MacNab criteria at 1 week after PEDD. Three patients (17.6%) who had advanced infections with multilevel involvement and paraspinal abscesses underwent anterior debridement and autograft interbody fusion with instrumentation within 2 weeks. However, there were no other severe surgery-related complications. Causative bacteria were identified in most cases, and Staphylococcus aureus was the most prevalent strain. CONCLUSIONS: Unilateral PEDD with physiological saline or empirical antibiotics did not disrupt lumbar stability and avoided the important intraspinal structures such as the dural sac and nerve roots. It not only had a high rate of identification of the causative pathogen, but also provided effective infection control and pain relief. PEDD may be a useful technique for treatment of lumbar infectious spondylodiscitis patients who have no severe deformities and are unable to undergo the conventional anterior surgery due to poor health or advanced age. |
format | Online Article Text |
id | pubmed-6276136 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-62761362018-12-06 Unilateral percutaneous endoscopic debridement and drainage for lumbar infectious spondylitis Wang, Xuepeng Zhou, Shaobo Bian, Zhenyu Li, Maoqiang Jiang, Wu Hou, Changju Zhu, Liulong J Orthop Surg Res Research Article BACKGROUND: The treatment of lumbar infectious spondylitis is controversial. In this study, we attempted to demonstrate that unilateral percutaneous endoscopic debridement with physiologic saline and negative pressure drainage postoperatively may achieve a satisfactory result in lumbar infectious spondylitis. METHODS: We retrospectively analyzed 17 patients with lumbar infectious spondylitis who underwent percutaneous endoscopic debridement and drainage (PEDD) through a posterolateral transforaminal approach. Each biopsy specimen was submitted without delay after surgery and examined for microorganisms and evaluated histopathologically. Patients were assessed by careful physical examination, MacNab criteria, Oswestry Disability Index (ODI), visual analog scale (VAS), regular serological tests, imaging studies for clinical function, and patient satisfaction. RESULTS: Of the 17 patients, 14 (82.4%) had satisfactory relief of their back pain according to MacNab criteria at 1 week after PEDD. Three patients (17.6%) who had advanced infections with multilevel involvement and paraspinal abscesses underwent anterior debridement and autograft interbody fusion with instrumentation within 2 weeks. However, there were no other severe surgery-related complications. Causative bacteria were identified in most cases, and Staphylococcus aureus was the most prevalent strain. CONCLUSIONS: Unilateral PEDD with physiological saline or empirical antibiotics did not disrupt lumbar stability and avoided the important intraspinal structures such as the dural sac and nerve roots. It not only had a high rate of identification of the causative pathogen, but also provided effective infection control and pain relief. PEDD may be a useful technique for treatment of lumbar infectious spondylodiscitis patients who have no severe deformities and are unable to undergo the conventional anterior surgery due to poor health or advanced age. BioMed Central 2018-12-03 /pmc/articles/PMC6276136/ /pubmed/30509282 http://dx.doi.org/10.1186/s13018-018-1009-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Wang, Xuepeng Zhou, Shaobo Bian, Zhenyu Li, Maoqiang Jiang, Wu Hou, Changju Zhu, Liulong Unilateral percutaneous endoscopic debridement and drainage for lumbar infectious spondylitis |
title | Unilateral percutaneous endoscopic debridement and drainage for lumbar infectious spondylitis |
title_full | Unilateral percutaneous endoscopic debridement and drainage for lumbar infectious spondylitis |
title_fullStr | Unilateral percutaneous endoscopic debridement and drainage for lumbar infectious spondylitis |
title_full_unstemmed | Unilateral percutaneous endoscopic debridement and drainage for lumbar infectious spondylitis |
title_short | Unilateral percutaneous endoscopic debridement and drainage for lumbar infectious spondylitis |
title_sort | unilateral percutaneous endoscopic debridement and drainage for lumbar infectious spondylitis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276136/ https://www.ncbi.nlm.nih.gov/pubmed/30509282 http://dx.doi.org/10.1186/s13018-018-1009-5 |
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