Department of Orthopedic, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China; Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
Center of Liver Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
Clin Neurol Neurosurg. 2020 Dec;199:106259. doi: 10.1016/j.clineuro.2020.106259. Epub 2020 Sep 30.
The aim of this study was to explore the efficacy and safety of surgical treatment of lumbar brucella spondylitis with PEEK cages combined with one-stage posterior debridement and instrumentation.
We performed a retrospective study for adult patients with lumbar brucella spondylitis. Medical records, imaging studies and laboratory data were collected, back pain was measured by employing the visual analog scale (VAS) and the neurological status was evaluated by using the American Spinal Injury Association (ASIA) scale.
A total of 61 consecutive patients (42 males and 19 females) were enrolled with the mean age at presentation of 56.33 ± 9.16 years old. L3-4 and L4-5 were the most infected levels with the ratios of 21.31 % and 19.67 % respectively. Moreover, 12 (19.67 %) patients suffered multiple-level infection and 5 (5/12, 41.67 %) of them had non-contiguous spondylitis. In addition, epidural masses were found in 26 (42.62 %) cases and psoas abscesses were found in 14 (22.95 %) cases. The number of operative segment depended on operation indications (failure of conservative measures, instability, kyphosis, intractable pain and/or neurological impairment). VAS scores were significantly improved at 6-weeks and the last follow-up. Among the 23 (37.70 %) patients with neurological deficits, 19 (19/23, 82.61 %) obtained a full recovery and 4 (4/23, 17.39 %) had been improved incompletely during the last follow-up. All patients exhibited satisfactory bone fusion during the last follow-up. Local infection of surgical site was identified in 6 (9.84 %) cases and no other surgery-related complications were found.
Use of PEEK cages for interbody fusion is feasible and safe in patients suffering from lumbar brucella spondylitis.
本研究旨在探讨 PEEK cage 联合一期后路清创固定术治疗腰椎布鲁氏菌性脊柱炎的疗效和安全性。
我们对成人腰椎布鲁氏菌性脊柱炎患者进行了回顾性研究。收集了病历、影像学检查和实验室数据，采用视觉模拟评分（VAS）评估腰痛，采用美国脊柱损伤协会（ASIA）评分评估神经功能状态。
共纳入 61 例连续患者（男 42 例，女 19 例），平均年龄 56.33±9.16 岁。L3-4 和 L4-5 是最常见的感染部位，比例分别为 21.31%和 19.67%。此外，12 例（19.67%）患者发生多节段感染，其中 5 例（5/12，41.67%）为非连续脊椎炎。此外，26 例（42.62%）患者有硬膜外肿块，14 例（22.95%）患者有腰大肌脓肿。手术节段的数量取决于手术指征（保守治疗失败、不稳定、后凸、难治性疼痛和/或神经功能障碍）。VAS 评分在 6 周和末次随访时均显著改善。在 23 例（37.70%）有神经功能缺损的患者中，19 例（19/23，82.61%）完全恢复，4 例（4/23，17.39%）在末次随访时恢复不完全。所有患者在末次随访时均表现出满意的骨融合。6 例（9.84%）患者发现手术部位局部感染，无其他与手术相关的并发症。
在腰椎布鲁氏菌性脊柱炎患者中，使用 PEEK cage 进行椎间融合是可行和安全的。
