Service de chirurgie du Rachis, hôpitaux universitaires de Strasbourg, 67200 Strasbourg, France.
Service de chirurgie du Rachis, hôpitaux universitaires de Strasbourg, 67200 Strasbourg, France.
Orthop Traumatol Surg Res. 2019 Oct;105(6):1165-1170. doi: 10.1016/j.otsr.2019.05.016. Epub 2019 Aug 27.
Patients with spondylodiscitis are treated with antibiotics and braces for 6 to 12 weeks. Braces aim to decrease pain and prevent kyphotic deformity due to vertebral body collapse. Percutaneous instrumentation could be an alternative to influence pain and patient's autonomy.
The purpose of this study was to analyze back pain, quality of life, sagittal deformity, and complications after percutaneous instrumentation in spondylodiscitis.
VAS for back pain, EQ-5D, radiographic sagittal index were assessed retrospectively for 28 patients who had a standardized follow-up at 5 days, 6 weeks, 3 months, 1 and 2 years. Probabilities>0.95 indicated significant changes (Bayesian model).
VAS was 7.0 preoperatively, 3.2 (day 5), 2.2 (6 weeks), 1.9 (3 months), 1.6 (1 year), 1.4 (2 years): probabilities>0.95 within 6 weeks. EQ-5D was 0.229 preoperatively, 0.563 (6 weeks), 0.687 (3 months), 0.755 (1 year), 0.787 (2 years): probabilities>0.95 within 1 year. Sagittal index was 15.1° preoperatively, 9.6° postoperatively: probability>0.95. Inter-body fusion was: complete 60.7%, partial 17.9%, and nonunion 21.4%. Antibiotic treatment was stopped at 6 weeks in 82.1%, at 3 months in 17.9%, without septic complication.
Percutaneous instrumentation improved pain control, quality of life and prevented kyphosis. Antibiotic treatment was not influenced. Septic complications were not observed.
IV.
患有脊椎骨髓炎的患者需要接受 6 至 12 周的抗生素和支具治疗。支具的目的是减轻疼痛并防止因椎体塌陷导致的脊柱后凸畸形。经皮器械固定术可能是影响疼痛和患者自主性的替代方法。
本研究旨在分析脊椎骨髓炎经皮器械固定术后的背痛、生活质量、矢状面畸形和并发症。
回顾性评估 28 例患者的视觉模拟评分（VAS）、EQ-5D 量表和影像学矢状面指数，这些患者在术后 5 天、6 周、3 个月、1 年和 2 年进行了标准化随访。概率>0.95 表示有显著变化（贝叶斯模型）。
VAS 术前为 7.0，术后第 5 天为 3.2，6 周时为 2.2，3 个月时为 1.9，1 年时为 1.6，2 年时为 1.4：6 周内概率>0.95。EQ-5D 术前为 0.229，术后第 6 周为 0.563，3 个月时为 0.687，1 年时为 0.755，2 年时为 0.787：1 年内概率>0.95。术前矢状面指数为 15.1°，术后为 9.6°：概率>0.95。椎间融合情况为：完全融合 60.7%，部分融合 17.9%，未融合 21.4%。6 周时 82.1%的患者停止使用抗生素治疗，3 个月时 17.9%的患者停止使用抗生素治疗，未出现感染性并发症。
经皮器械固定术改善了疼痛控制、生活质量并预防了脊柱后凸。抗生素治疗未受影响。未观察到感染性并发症。
IV。
