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后路单入路清创病灶清除联合椎体切除治疗椎体骨水泥强化术后化脓性脊柱炎

Debridement and corpectomy via single posterior approach to treat pyogenic spondylitis after vertebral augmentation.

机构信息

Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, NO. 25 Taiping Street, Sichuan, 646000, Luzhou City, China.

出版信息

BMC Musculoskelet Disord. 2021 Jun 26;22(1):591. doi: 10.1186/s12891-021-04478-0.

DOI:10.1186/s12891-021-04478-0
PMID:34174863
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8236162/
Abstract

BACKGROUND

Infection after vertebral augmentation (VA) often limits the daily activities of patients and even threatens their life. The operation may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability. This study aimed to investigate the clinical efficacy of the treatment of pyogenic spondylitis after vertebral augmentation (PSVA) with Single posterior debridement, vertebral body resection, and intervertebral bone graft fusion and internal fixation (sPVRIF).

METHODS

The study was performed on 19 patients with PSVA who underwent VA at 4 hospitals in the region between January 2010 and July 2020. Nineteen patients were included. Among them, 16 patients underwent sPVRIF to treat the PSVA.

RESULTS

A total of 2267 patients underwent VA at 4 hospitals in the region. Of the 19 patients with postoperative PSVA, suppurative spondylitis was misdiagnosed as an osteoporotic vertebral fracture(OVF) in 4 patients and they underwent VA. Besides osteoporosis, 18 patients had other comorbidities. The average interval between the first surgery and the diagnosis of PSVA was 96.4 days. Of the 19 patients, 16 received surgical treatment. The surgical time was 175.0±16.8 min, and the intraoperative blood loss was 465.6±166.0 mL. Pathogenic microorganisms were cultured in 12 patients.

CONCLUSION

PSVA is a severe complication that can even threaten the life of the patients. sPVRIF may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability.

摘要

背景

椎体增强(VA)术后感染常限制患者的日常活动,甚至威胁生命。如果患者出现难以忍受的剧烈疼痛、神经功能缺损和脊柱稳定性受损,手术可能是一种有效的治疗方法。本研究旨在探讨后路单纯清创、椎体切除、椎间植骨融合内固定(sPVRIF)治疗椎体增强术后化脓性脊柱炎(PSVA)的临床疗效。

方法

研究对象为 2010 年 1 月至 2020 年 7 月在该地区 4 家医院接受 VA 治疗的 19 例 PSVA 患者。19 例患者均采用 sPVRIF 治疗 PSVA。

结果

该地区 4 家医院共 2267 例患者接受 VA 治疗。19 例术后 PSVA 患者中,4 例误诊为骨质疏松性椎体骨折(OVF)而接受 VA 治疗。除骨质疏松症外,18 例患者还存在其他合并症。首次手术与 PSVA 诊断的平均间隔时间为 96.4 天。19 例患者中,16 例接受手术治疗。手术时间为 175.0±16.8min,术中出血量为 465.6±166.0ml。12 例患者培养出病原菌。

结论

PSVA 是一种严重的并发症,甚至可能威胁到患者的生命。如果患者出现难以忍受的剧烈疼痛、神经功能缺损和脊柱稳定性受损,sPVRIF 可能是一种有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a73/8236162/bc989de30849/12891_2021_4478_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a73/8236162/cda7309c7581/12891_2021_4478_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a73/8236162/bc989de30849/12891_2021_4478_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a73/8236162/cda7309c7581/12891_2021_4478_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a73/8236162/bc989de30849/12891_2021_4478_Fig2_HTML.jpg

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