Yuan Shuo, Ma Fengyu, Wang Yexin, Gong Pihao
Affiliated Hospital of Jining Medical University, Jining, China.
Wideochir Inne Tech Maloinwazyjne. 2019 Apr;14(2):333-339. doi: 10.5114/wiitm.2018.78891. Epub 2018 Oct 11.
Pyogenic spondylodiscitis is a bacterial infection affecting the intervertebral disc and its adjacent vertebrae. Although relatively rare, it is a challenging medical disease with a poor prognosis that requires immediate diagnosis and treatment with suitable antibiotics.
To evaluate the clinical outcome of minimally invasive spine surgery (MIS) for pyogenic spondylodiscitis.
The retrospective study cohort consisted of 10 consecutive patients who had undergone MIS decompression and/or discectomy for thoracic or lumbar pyogenic spondylodiscitis in our hospital. Data including patient characteristics, symptoms, visual analog scale (VAS) score, surgical approach and postoperative outcomes were obtained for retrospective analysis.
Between January 2005 and December 2013, 10 patients underwent MIS decompression in the Department of Orthopedics in our medical university. Seven of these patients had lumbar infections and 3 had thoracic infections. All 10 patients had improved VAS scores immediately after surgery and after discharge. The VAS score (respectively on postoperative day 1 and day 7) suggested that the patients in this study had significantly less pain than preoperatively (day 1: 5 vs. 9, p < 0.001; day 7: 2.9 vs. 9, p < 0.001). The organism was obtained in 10 (100%) patients by the operative cultures. All patients achieved an excellent clinical recovery without the need for further spine surgery. All patients underwent postoperative imaging during follow-up and showed complete resolution or dramatically improved magnetic resonance imaging changes.
Minimally invasive spine surgery is a safe and effective surgical approach for pyogenic spondylodiscitis.
化脓性脊椎间盘炎是一种影响椎间盘及其相邻椎体的细菌感染。尽管相对罕见，但它是一种具有挑战性的医学疾病，预后较差，需要立即诊断并用合适的抗生素进行治疗。
评估微创脊柱手术（MIS）治疗化脓性脊椎间盘炎的临床效果。
回顾性研究队列包括在我院接受MIS减压和/或椎间盘切除术治疗胸段或腰段化脓性脊椎间盘炎的10例连续患者。获取包括患者特征、症状、视觉模拟量表（VAS）评分、手术方式和术后结果等数据进行回顾性分析。
2005年1月至2013年12月，我校医学院骨科有10例患者接受了MIS减压手术。其中7例患者为腰部感染，3例为胸部感染。所有10例患者术后及出院后VAS评分均有所改善。VAS评分（分别在术后第1天和第7天）表明，本研究中的患者疼痛明显比术前减轻（第1天：5分对9分，p<0.001；第7天：2.9分对9分，p<0.001）。通过手术培养在10例（100%）患者中获取了病原体。所有患者均实现了良好的临床康复，无需进一步的脊柱手术。所有患者在随访期间均接受了术后影像学检查，结果显示磁共振成像改变完全消失或显著改善。
微创脊柱手术是治疗化脓性脊椎间盘炎的一种安全有效的手术方法。
