Endres Stefan, Wilke Axel
Department of Orthopaedic Surgery, Elisabeth-Klinik Bigge/Olsberg, Olsberg, Germany.
J Orthop Surg (Hong Kong). 2012 Apr;20(1):1-6. doi: 10.1177/230949901202000101.
To report outcomes of 7 patients with bacterial spondylodiscitis treated through a posterior approach.
Five men and 2 women aged 40 to 80 years underwent one-stage posterior interbody debridement and instrumentation for single-segment bacterial spondylodiscitis of lumbar (n=5) or thoracic (n=2) vertebrae. The Oswestry Disability Score, the Frankel classification, the Cobb angle, and the visual analogue scale (VAS) for pain as well as bone union on radiographs were assessed.
Patients were followed up for 19 to 36 months. None had relapses or complications. Postoperatively, 5 patients had no pain or used analgesics only occasionally; their VAS scores varied from 0 to 20. The remaining 2 patients had residual symptoms and received regular peripheral pain medication and opiates; their VAS scores ranged from 30 to 50. The mean Oswestry Disability Score improved to 21 (range, 12-38). The mean Cobb angle improved from 13.1 to 11.1 degrees. The segments were probably fused in 5 patients and questionable in 2.
Posterior debridement and instrumentation was adequate for single-segment spondylodiscitis and achieved good outcomes.
报告7例采用后路手术治疗的细菌性脊椎椎间盘炎患者的治疗结果。
5例男性和2例女性，年龄40至80岁，因腰椎（n = 5）或胸椎（n = 2）单节段细菌性脊椎椎间盘炎接受一期后路椎间清创及内固定术。评估Oswestry功能障碍评分、Frankel分级、Cobb角、疼痛视觉模拟量表（VAS）以及X线片上的骨融合情况。
患者随访19至36个月。无复发及并发症发生。术后，5例患者无疼痛或仅偶尔使用镇痛药；其VAS评分在0至20分之间。其余2例患者有残留症状，接受常规外周疼痛药物和阿片类药物治疗；其VAS评分在30至50分之间。Oswestry功能障碍评分平均改善至21分（范围12 - 38分）。Cobb角平均从13.1度改善至11.1度。5例患者节段可能融合，2例情况可疑。
后路清创及内固定术对单节段脊椎椎间盘炎治疗充分，效果良好。
