Zhang Liang, Cai Wei-Hua, Huang Bo, Chen Lin-Wei, Zhang Ning, Ni Bin
Dept of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Acta Orthop Belg. 2011 Dec;77(6):816-22.
Spontaneous infectious spondylodiscitis (SIS) is an uncommon condition. The purpose of this retrospective study of 10 adult patients (6 males and 4 females, average age 52 years), all with lumbar SIS and epidural abscess, was to analyze the efficacy of single-stage posterior debridement plus single-level interbody grafting with autologous bone, and transpedicular screw-rod instrumentation. The mean follow-up period was 43 months, with a minimum of 30 months. The back pain was relieved within 3 to 8 days after surgery. Neurologic deficits, present in 5 cases, all improved. Solid fusion was achieved at 6 months in all 10 cases. The mean VAS for pain improved from 7.5 to 1.6, the mean Oswestry Disability Index from 57.8% to 8.1%. The mean physical component of SF-36 (PCS) improved from 32.4% to 54.7%, the mean mental component of SF-36 (MCS) improved from 33.8% to 57.2%. All these changes were significant (p < 0.001). No recurrence of infection was noted. The outcome was quite satisfactory in terms of fusion rate and quality of life.
自发性感染性脊椎椎间盘炎（SIS）是一种罕见疾病。本回顾性研究纳入了10例成年患者（6例男性，4例女性，平均年龄52岁），均患有腰椎SIS并伴有硬膜外脓肿，旨在分析一期后路清创联合自体骨单节段椎间植骨及经椎弓根螺钉棒内固定的疗效。平均随访期为43个月，最短30个月。术后3至8天背痛缓解。5例存在神经功能缺损的患者均有改善。10例患者均在6个月时实现了牢固融合。疼痛视觉模拟评分（VAS）均值从7.5改善至1.6，奥斯威斯功能障碍指数（ODI）均值从57.8%降至8.1%。简明健康状况调查量表（SF-36）的平均生理健康评分（PCS）从32.4%提高至54.7%，平均心理健康评分（MCS）从33.8%提高至57.2%。所有这些变化均具有显著性（p < 0.001）。未观察到感染复发。就融合率和生活质量而言，结果相当令人满意。
