Xu Jianbiao, Zhang Leiming, Bu Rongqiang, Liu Yankang, Lewandrowski Kai-Uwe, Zhang Xifeng
Department of Orthopaedics,First, Affiliated Hospital of Tsinghua University(Beijing Huaxin Hospital), Beijing, China.
School of Clinical Medicine, Tsinghua University, Beijing, China.
BMC Musculoskelet Disord. 2021 Jan 29;22(1):120. doi: 10.1186/s12891-021-03988-1.
Spondylodiscitis is an unusual infectious disease, which usually originates as a pathogenic infection of intervertebral discs and then spreads to neighboring vertebral bodies. The objective of this study is to evaluate percutaneous debridement and drainage using intraoperative CT-Guide in multilevel spondylodiscitis.
From January 2002 to May 2017, 23 patients with multilevel spondylodiscitis were treated with minimally invasive debridement and drainage procedures in our department. The clinical manifestations, evolution, and minimally invasive debridement and drainage treatment of this refractory vertebral infection were investigated.
Of the enrolled patients, the operation time ranged from 30 minutes to 124 minutes every level with an average of 48 minutes. Intraoperative hemorrhage was minimal. The postoperative follow-up period ranged from 12 months to 6.5 years with an average of 3.7 years. There was no reactivation of infection in the treated vertebral segment during follow-up, but two patients with fungal spinal infection continued to progress by affecting adjacent segments prior to final resolution. According to the classification system of Macnab, one patient had a good outcome at the final follow-up, and the rest were excellent.
Minimally invasive percutaneous debridement and irrigation using intraoperative CT-Guide is an effective minimally invasive method for the treatment of multilevel spondylodiscitis.
脊椎椎间盘炎是一种罕见的感染性疾病,通常起源于椎间盘的病原感染,然后扩散至相邻椎体。本研究的目的是评估术中CT引导下经皮清创引流术在多节段脊椎椎间盘炎治疗中的应用。
2002年1月至2017年5月,我科对23例多节段脊椎椎间盘炎患者采用微创清创引流术进行治疗。对这种难治性椎体感染的临床表现、病情发展及微创清创引流治疗进行了研究。
纳入患者中,每节段手术时间为30分钟至124分钟,平均48分钟。术中出血极少。术后随访时间为12个月至6.5年,平均3.7年。随访期间,治疗的椎体节段未出现感染复发,但2例真菌性脊柱感染患者在最终治愈前,相邻节段仍继续受到影响。根据Macnab分类系统,末次随访时1例患者效果良好,其余患者效果优秀。
术中CT引导下微创经皮清创冲洗术是治疗多节段脊椎椎间盘炎的一种有效的微创方法。