Department of Neurosurgery, University Hospital of Bonn, Venusberg-Campus 1, Building 81, 53127, Bonn, Germany.
Center for Advanced Imaging Research, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Marlene and Stewart Greenebaum, Comprehensive Cancer, Center University of Maryland, Baltimore, USA.
J Orthop Surg Res. 2023 Feb 15;18(1):107. doi: 10.1186/s13018-023-03584-0.
Retrospective single center cohort study.
Spinal instrumentation in combination with antibiotic therapy is a treatment option for acute or chronic pyogenic spondylodiscitis (PSD). This study compares the early fusion outcome for multi-level and single-level PSD after urgent surgical treatment with interbody fusion in combination with fixation.
This is a retrospective cohort study. Over a 10 year period at a single institution, all surgically treated patients received surgical debridement, fusion und fixation of the spine to treat PSD. Multi-level cases were either adjacent to each other on the spine or distant. Fusion rates were assessed at 3 and 12 months after surgery. We analyzed demographic data, ASA status, duration of surgery, location and length of spine affected, Charlson comorbidity index (CCI), and early complications.
A total of 172 patients were included. Of these, 114 patients suffered from single-level and 58 from multi-level PSD. The most frequent location was the lumbar spine (54.0%) followed by the thoracic spine (18.0%). The PSD was adjacent in 19.0% and distant in 81.0% of multi-level cases. Fusion rates at the 3 month follow-up did not differ among the multi-level group (p = 0.27 for both adjacent and distant sites). In the single-level group, sufficient fusion was achieved in 70.2% of cases. Pathogen identification was possible 58.5% of the time.
Surgical treatment of multi-level PSD is a safe option. Our study demonstrates that there was no significant difference in early fusion outcomes between single-level and multi-level PSD, whether adjacent or distant.
回顾性单中心队列研究。
脊柱内固定联合抗生素治疗是治疗急性或慢性化脓性脊椎炎（PSD）的一种选择。本研究比较了多节段和单节段 PSD 在紧急手术治疗后路椎间融合内固定后的早期融合结果。
这是一项回顾性队列研究。在一家机构的 10 年期间，所有接受手术治疗的患者均接受手术清创、脊柱融合和固定以治疗 PSD。多节段病变位于脊柱相邻或远处。术后 3 个月和 12 个月评估融合率。我们分析了人口统计学数据、ASA 状态、手术持续时间、脊柱受累部位和长度、Charlson 合并症指数（CCI）和早期并发症。
共纳入 172 例患者，其中 114 例为单节段 PSD，58 例为多节段 PSD。最常见的部位是腰椎（54.0%），其次是胸椎（18.0%）。多节段病变中，相邻病变占 19.0%，远处病变占 81.0%。3 个月随访时，多节段组的融合率无差异（相邻和远处部位的 p 值均为 0.27）。在单节段组，70.2%的病例融合充分。58.5%的病例能够明确病原体。
多节段 PSD 的手术治疗是一种安全的选择。我们的研究表明，无论是相邻还是远处，单节段和多节段 PSD 的早期融合结果没有显著差异。
