Neurosurgery Department, La Timone Teaching Medical Center, 249, rue Saint-Pierre, 13005 Marseille, France.
Orthop Traumatol Surg Res. 2009 May;95(3):220-3. doi: 10.1016/j.otsr.2009.03.002. Epub 2009 Apr 17.
Surgically managed bacterial spondylitis is rare, and a variety of operative techniques are currently available, without any real consensus. The present study reports an original, less invasive surgical treatment for spondylitis, in two patients. An initial percutaneous posterior instrumentation fixation was followed by an anterior interbody graft performed through a retroperitoneal route. Postoperative bacterial typing was done; pain resolution was obtained in both patients. Control CT scan showed good restitution of the disk space height and a satisfactory reduction of the local kyphosis. Fusion was achieved at 6 months in both cases, with stable results at long-term follow-up. In patients presenting comorbid conditions, this technique gave interesting preliminary results, was less traumatic and shorter to perform, and finally entailed a limited operative risk.
手术治疗细菌性脊柱炎较为少见,目前有多种手术技术可供选择,但尚无明确共识。本研究报告了 2 例采用原始微创外科手术治疗脊柱炎的病例。首先进行经皮后路器械内固定,然后通过腹膜后入路进行前路椎间植骨。术后进行细菌分型;2 例患者的疼痛均得到缓解。术后 CT 扫描显示,椎间盘高度恢复良好,局部后凸畸形得到满意矫正。2 例患者均在 6 个月时融合,长期随访结果稳定。对于合并疾病的患者,该技术具有良好的初步效果,创伤更小,手术时间更短,最终手术风险有限。