One-stage posterior debridement and fusion mixed with irrigation and drainage for the therapy of postoperative lumbar spondylodiscitis.
Acta Orthop Traumatol Turc. 2018 Could 17;:
Authors: Zhang T, Hu J, Wu J, Liu J, Ni S, Duan C
OBJECTIVE: The intention of this research was to guage the scientific outcomes of one-stage posterior debridement, interbody fusion, and instrumentation, mixed with irrigation and drainage, for treating lumbar spondylodiscitis.
METHODS: The research included 23 sufferers (13 male and 10 feminine, imply age: 45 years) who had posterior debridement, interbody fusion, and instrumentation, adopted by steady closed irrigation and drainage for lumbar postoperative spondylodiscitis. The visible analog scale, Oswestry incapacity index, and lumbar lordosis angle had been assessed earlier than and after surgical procedure to guage the scientific consequence.
RESULTS: The imply follow-up time was 27 (24-36) months. All sufferers tolerated the process nicely, and there have been no situations of spondylodiscitis recurrence, although a dorsal dermal sinus developed in a single affected person after surgical procedure. An infection was eradicated, as evidenced by the normalization of the erythrocyte sedimentation charges and C-reactive protein ranges. The imply visible analog scale scores had been considerably decreased after the operation. The imply lumbar lordosis angle earlier than surgical procedure was 21.61 ± 6.88° and the angle on the ultimate follow-up was 31.61 ± four.24°. The imply Oswestry incapacity index scores improved considerably each after the operation and on the follow-up visits (p < zero.05). Bone union was confirmed in all sufferers at a imply of eight.6 months post-operation, although this was not achieved till 2 years post-operation in a single affected person. All three sufferers who had neurological deficits confirmed nice enchancment on the final follow-up.
CONCLUSION: Surgical administration utilizing one-stage posterior debridement, interbody fusion, and instrumentation, adopted by steady closed irrigation and drainage, could be an efficient therapy choice for lumbar postoperative spondylodiscitis.
LEVEL OF EVIDENCE: Degree IV, Therapeutic research.
PMID: 29779968 [PubMed – as supplied by publisher]