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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.

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/4cb0/11334069/28d9a81f4b4e/rjae521f1.jpg

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