Department of Orthopaedic Surgery, Ota Memorial Hospital, Gunma 373-8585, Japan.
Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita 286-0048, Japan.
Medicina (Kaunas). 2022 Jun 1;58(6):754. doi: 10.3390/medicina58060754.
The incidence of pyogenic spondylodiscitis has been increasing due to the aging of the population. Although surgical treatment is performed for refractory pyogenic spondylodiscitis, surgical invasiveness should be considered. Recent minimally invasive spine stabilization (MISt) using percutaneous pedicle screw (PPS) can be a less invasive approach. The purpose of this study was to evaluate surgical results and clinical outcomes after MISt with PPS for pyogenic spondylodiscitis. Clinical data of patients who underwent MISt with PPS for pyogenic spondylitis were analyzed. Twenty-three patients (18 male, 5 female, mean age 67.0 years) were retrospectively enrolled. The mean follow-up period was 15.9 months after surgery. The causative organism was identified in 16 cases (69.6%). A mean number of fixed vertebrae was 4.1, and the estimated blood loss was 145.0 mL. MISt with PPS was successfully performed in 19 of 23 patients (82.6%). Four cases (17.4%) required additional anterior debridement and autologous iliac bone graft placement. CRP levels had become negative at an average of 28.4 days after surgery. There was no major perioperative complication and no screw or rod breakages during follow-up. MISt with PPS would be a less invasive approach for pyogenic spondylodiscitis in elderly or immunocompromised patients.
化脓性脊椎炎的发病率因人口老龄化而增加。虽然对于难治性化脓性脊椎炎会进行手术治疗，但应考虑手术的侵袭性。最近使用经皮椎弓根螺钉（PPS）的微创脊柱稳定（MISt）可以是一种侵袭性较小的方法。本研究旨在评估 MISt 联合 PPS 治疗化脓性脊椎炎的手术结果和临床结果。 分析了接受 MISt 联合 PPS 治疗化脓性脊椎炎的患者的临床数据。 共纳入 23 例患者（18 名男性，5 名女性，平均年龄 67.0 岁），回顾性研究。术后平均随访 15.9 个月。16 例（69.6%）确定了病原体。固定椎体的平均值为 4.1 个，估计出血量为 145.0 毫升。23 例患者中有 19 例（82.6%）成功完成了 MISt 联合 PPS。4 例（17.4%）需要额外进行前路清创和自体髂骨移植。术后平均 28.4 天 CRP 水平转为阴性。在随访期间没有发生重大围手术期并发症，也没有螺钉或棒断裂。 MISt 联合 PPS 对于老年或免疫功能低下的化脓性脊椎炎患者是一种侵袭性较小的方法。
