Eysel P, Hopf C, Vogel I, Rompe J D
Orthopaedic University Hospital Mainz, Germany.
Eur Spine J. 1997;6(3):152-7. doi: 10.1007/BF01301428.
The operative results of 23 patients with a specific or unspecific spondylodiscitis were documented over 2 years after the focus of the inflammation had been eradicated, bone chip had been interposed and a CDH instrumentation had been performed by an anterior approach only. These outcomes were compared with the results of 32 patients in whom the focus had been removed and the defect had been filled with bone graft from an anterior approach, followed by stabilisation with CD instrumentation through an additional dorsal approach. In the cases where CDH instrumentation was applied, the range of fusion averaged 1.3 segments. This was clearly less extensive than in dorsoventral stabilisation, in which on average 3.5 segments were fused. In 47 of 55 cases mobilisation was achieved without orthesis. Eight months after the operations bony fusion could be observed radiologically in all patients. The mean preoperative kyphotic angle of the affected segments was 14.4 degrees, compared to 4 degrees after the operation. The mean loss of reposition was measured to be about 2.7 degrees in both groups. Average operation time and blood loss were about 50% higher in the patients treated dorsoventrally. We conclude that even in the case of florid spondylodiscitis, a short-range anterior fusion of the affected spinal segment may be performed by use of a stable-angle implant without an increased risk of infection-related loosening.
对23例患有特异性或非特异性脊椎椎间盘炎的患者进行了手术治疗，在炎症病灶根除、植入骨块并仅通过前路进行CDH器械固定后，记录了2年以上的手术结果。将这些结果与32例患者的结果进行比较，这些患者通过前路切除病灶并用骨移植填充缺损，然后通过额外的后路进行CD器械固定以实现稳定。在应用CDH器械固定的病例中，融合范围平均为1.3个节段。这明显比前后路稳定术的范围小，前后路稳定术中平均融合3.5个节段。55例患者中有47例无需支具即可实现活动。术后8个月，所有患者在影像学上均可见骨融合。患段术前平均后凸角为14.4度，术后为4度。两组的平均复位丢失量约为2.7度。前后路治疗的患者平均手术时间和失血量高出约50%。我们得出结论，即使在急性脊椎椎间盘炎的情况下，使用稳定角植入物对受影响的脊柱节段进行短节段前路融合，也不会增加与感染相关的松动风险。
