Department of Orthopedics, 960th Hospital of PLA, Jinan, 250031 Shandong, China.
Oxid Med Cell Longev. 2022 Oct 15;2022:6241818. doi: 10.1155/2022/6241818. eCollection 2022.
Minimally invasive or open surgery is contentious in the treatment of spondylodiscitis, therefore finding a balance between the two is urgently needed. In this study, we propose a new treatment paradigm for treating spontaneous lumbar spondylodiscitis by percutaneous endoscopic lumbar debridement and irrigation drainage (PELDID). Then, the Pola classification was used to guide subsequent treatment.
From November 2017 to April 2019, this study collected data on 16 patients with lumbar spondylodiscitis who were surgically treated utilizing this treatment paradigm in our department. Clinical effectiveness was determined using the visual analogue scale (VAS), the Oswestry Disability Index (ODI), the MOS 36-item short-form health survey (SF-36), and Kirkaldy-Willis criteria.
All 16 patients completed the treatment using the above paradigm and were followed up for 28.13 ± 10.15 months. The preoperative Pola classification is as follows: 7 cases of type A, 3 cases of type B, and 6 cases of type C. After the first-stage surgery, the evaluation results of Pola classification were as follows: 8 cases of type A, 8 cases of type B, and 0 cases of type C. Four patients received second-stage surgery with internal fixation through the paravertebral multifidus space approach and intervertebral bone graft fusion through the transforaminal approach, and the reoperation rate was 25% (4/16 cases). The Visual analogue scale (VAS), Oswestry Disability Index (ODI), and SF-36 score all improved significantly from 2.43 ± 0.89 to 0.18 ± 0.40, from 77.31% ± 11.15%to 16.93% ± 5.45%, and from 18.34 ± 7.47 to 80.3 ± 15.36. The CRP and ESR decreased dramatically from 49.61 ± 48.84 to12.50 ± 12.18 and from 65.56 ± 26.89 to 29.68 ± 20.68. There were no recurrences of infection in our study.
The paradigm of the first-stage PELDID technique combined with the Pola classification system to guide the second-stage treatment for spontaneous spondylodiscitis is a novel and effective strategy for treating spontaneous spondylodiscitis.
微创或开放手术在治疗脊椎炎方面存在争议，因此迫切需要在两者之间找到平衡。在这项研究中，我们提出了一种通过经皮内窥镜腰椎清创灌洗（PELDID）治疗自发性腰椎脊椎炎的新治疗模式。然后，使用 Pola 分类来指导后续治疗。
从 2017 年 11 月至 2019 年 4 月，我们部门对 16 例接受该治疗模式治疗的腰椎脊椎炎患者进行了数据收集。使用视觉模拟量表（VAS）、Oswestry 残疾指数（ODI）、MOS 36 项短式健康调查（SF-36）和 Kirkaldy-Willis 标准来确定临床疗效。
所有 16 例患者均完成了上述治疗模式的治疗，并进行了 28.13±10.15 个月的随访。术前 Pola 分类如下：7 例 A 型，3 例 B 型，6 例 C 型。一期手术后，Pola 分类评估结果如下：8 例 A 型，8 例 B 型，0 例 C 型。4 例患者接受了经椎间孔入路椎旁多裂肌间隙入路内固定和经椎间孔入路植骨融合的二期手术，再手术率为 25%（4/16 例）。视觉模拟量表（VAS）、Oswestry 残疾指数（ODI）和 SF-36 评分均从 2.43±0.89 显著改善至 0.18±0.40、77.31%±11.15%至 16.93%±5.45%和 18.34±7.47 至 80.3±15.36。CRP 和 ESR 从 49.61±48.84 显著下降至 12.50±12.18 和从 65.56±26.89 下降至 29.68±20.68。在本研究中，没有感染复发的病例。
一期 PELDID 技术联合 Pola 分类系统指导二期治疗自发性脊椎炎的治疗模式是治疗自发性脊椎炎的一种新颖而有效的策略。
