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腰椎骨髓炎的前后路手术方法

Anterior and posterior surgical approach for vertebral lumbar osteomyelitis.

作者信息

Patel Jay, Malkoc Aldin, Ghauri Muhammad S, Amin Luv, Petersen Morgan, Cochrane Julia, Hopkins Gail, Schwartz Samuel

机构信息

Department of Vascular Surgery, California University of Science and Medicine, 1501 Violet Street, Colton, CA 92324, United States.

Department of Vascular Surgery, Arrowhead Regional Medical Center, 400 N Pepper Ave, Colton, CA 92324, United States.

出版信息

J Surg Case Rep. 2024 Aug 20;2024(8):rjae521. doi: 10.1093/jscr/rjae521. eCollection 2024 Aug.

DOI:10.1093/jscr/rjae521
PMID:39165608
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11334069/
Abstract

() infections primarily affect immunocompromised patients who commonly present with non-orthopedic infections. We present a case of a 63-year-old female presented with persistent back pain and radicular pain. Computed tomography and magnetic resonance imaging showed a large multiloculated anterior epidural abscess. We show here the unique occurrence of lumbar vertebral osteomyelitis, which was treated with L2 and L3 corpectomies, anterior lumbar interbody fusion, and posterior instrumentation via an anterolateral thoracoabdominal (TA) incision. Vascular surgery provided L1-L4 spine exposure via a left anterolateral TA incision, whereas orthopedic surgery performed L2 and L3 corpectomies with lumbar cage placement and posterior instrumentation in two separate procedures. The patient was discharged to a skilled nursing facility, retaining all neurological function, and is progressing well on follow-up.

摘要

()感染主要影响免疫功能低下的患者,这些患者通常表现为非骨科感染。我们报告一例63岁女性患者,出现持续性背痛和神经根性疼痛。计算机断层扫描和磁共振成像显示一个巨大的多房性硬膜外前脓肿。我们在此展示了腰椎骨髓炎的独特病例,该病例通过L2和L3椎体次全切除术、前路腰椎椎间融合术以及经胸腹部前外侧(TA)切口进行后路内固定治疗。血管外科通过左胸腹部前外侧TA切口暴露L1-L4脊柱,而骨科手术在两个单独的手术中进行L2和L3椎体次全切除术,并置入腰椎椎间融合器和后路内固定。患者出院后入住专业护理机构,保留了所有神经功能,随访情况良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cb0/11334069/add05330b7cd/rjae521f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cb0/11334069/28d9a81f4b4e/rjae521f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cb0/11334069/832b63f12a47/rjae521f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cb0/11334069/add05330b7cd/rjae521f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cb0/11334069/28d9a81f4b4e/rjae521f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cb0/11334069/832b63f12a47/rjae521f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cb0/11334069/add05330b7cd/rjae521f3.jpg

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本文引用的文献

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Cureus. 2023 Jan 11;15(1):e33668. doi: 10.7759/cureus.33668. eCollection 2023 Jan.
2
Surgical Management of Spinal Tuberculosis-The Past, Present, and Future.脊柱结核的外科治疗——过去、现在与未来
Diagnostics (Basel). 2022 May 24;12(6):1307. doi: 10.3390/diagnostics12061307.
3
-associated vertebral osteomyelitis in an immunocompetent patient: a rare case report and literature review.
免疫功能正常患者的相关脊椎骨髓炎:一例罕见病例报告及文献综述
Spinal Cord Ser Cases. 2019 May 31;5:53. doi: 10.1038/s41394-019-0197-5. eCollection 2019.
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Treatment of Mycobacterium abscessus Infection.脓肿分枝杆菌感染的治疗
Emerg Infect Dis. 2016 Mar;22(3):511-4. doi: 10.3201/eid2203.150828.
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Bacterial Spine Infections in Adults: Evaluation and Management.成人细菌性脊柱感染:评估与管理
J Am Acad Orthop Surg. 2016 Jan;24(1):11-8. doi: 10.5435/JAAOS-D-13-00102.
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Vertebral Osteomyelitis Caused by Mycobacterium abscessus Surgically Treated Using Antibacterial Iodine-Supported Instrumentation.使用载有抗菌碘的器械手术治疗脓肿分枝杆菌引起的脊椎骨髓炎。
Case Rep Orthop. 2014;2014:197061. doi: 10.1155/2014/197061. Epub 2014 Dec 2.
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Anterior versus posterior procedure for surgical treatment of thoracolumbar tuberculosis: A retrospective analysis.胸腰椎结核手术治疗的前路与后路手术:一项回顾性分析。
Indian J Orthop. 2012 Mar;46(2):165-70. doi: 10.4103/0019-5413.93682.
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An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases.美国胸科学会/美国感染病学会官方声明:非结核分枝杆菌病的诊断、治疗与预防
Am J Respir Crit Care Med. 2007 Feb 15;175(4):367-416. doi: 10.1164/rccm.200604-571ST.
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