Fu Tsai-Sheng, Yang Shih-Chieh, Tsai Tsung-Ting, Chen Lih-Huei, Lai Po-Liang, Niu Chi-Chieh, Chen Wen-Jer
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taiwan.
Minim Invasive Ther Allied Technol. 2010;19(1):42-7. doi: 10.3109/13645700903384450.
Percutaneous endoscopic debridement and drainage (PEDD) has been reported to be an effective procedure in treating early infectious spondylodiscitis. However, it is not clear whether PEDD can be effective in treating cases of complicated infectious spondylitis with significant abscess formation or vertebral destruction. Two women and four men with poor general health and complicated pyogenic spondylitis who underwent PEDD were evaluated. The causative bacteria were identified by PEDD in five of six. All six patients presented with spinal pain. Five patients reported relief from back pain within one week of surgery and recovered uneventfully after full course, specific, antimicrobial therapy. C-reactive protein (CRP) values returned to normal ranges within two to 22 weeks in these patients. The follow-up magnetic resonance imaging studies revealed that the paraspinal abscesses or epidural abscesses were resolved. No surgery-related complications were noted during or after the PEDD procedure. In conclusion, PEDD was effective in treating complicated infectious spondylitis. We propose that PEDD is an effective alternative to extensive surgery for complicated infectious spondylitis, especially in patients with multiple comorbidities.
经皮内镜清创引流术（PEDD）已被报道为治疗早期感染性脊椎椎间盘炎的有效方法。然而，PEDD对于治疗伴有大量脓肿形成或椎体破坏的复杂性感染性脊柱炎是否有效尚不清楚。我们评估了6例接受PEDD治疗、全身状况较差且患有复杂性化脓性脊柱炎的患者，其中2例女性，4例男性。6例中有5例通过PEDD确定了致病菌。所有6例患者均有脊柱疼痛。5例患者在术后1周内背痛缓解，经过全程、特异性抗菌治疗后顺利康复。这些患者的C反应蛋白（CRP）值在2至22周内恢复到正常范围。随访磁共振成像研究显示，椎旁脓肿或硬膜外脓肿已消退。在PEDD手术期间及术后未发现与手术相关的并发症。总之，PEDD治疗复杂性感染性脊柱炎有效。我们认为，对于复杂性感染性脊柱炎，尤其是合并多种疾病的患者，PEDD是广泛手术的有效替代方法。
