Posterolateral full-endoscopic debridement and irrigation is effective in treating thoraco-lumbar pyogenic spondylodiscitis, except in cases with large abscess cavities.

Autor: Yamada, Katsuhisa, Takahata, Masahiko, Nagahama, Ken, Iwata, Akira, Endo, Tsutomu, Fujita, Ryo, Hasebe, Hiroyuki, Ohnishi, Takashi, Sudo, Hideki, Ito, Manabu, Iwasaki, Norimasa
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Zdroj: European Spine Journal; Mar2023, Vol. 32 Issue 3, p859-866, 8p, 1 Black and White Photograph, 1 Diagram, 2 Charts, 1 Graph
Abstrakt: Purpose: To determine the efficacy and poor prognostic factors of posterolateral full-endoscopic debridement and irrigation (PEDI) surgery for thoraco-lumbar pyogenic spondylodiscitis. Methods: We included 64 patients (46 men, 18 women; average age: 63.7 years) with thoracic/lumbar pyogenic spondylodiscitis who had undergone PEDI treatment and were followed up for more than 2 years. Clinical outcomes after PEDI surgery were retrospectively investigated to analyze the incidence and risk factors for prolonged and recurrent infection. Results: Of 64 patients, 53 (82.8%) were cured of infection after PEDI surgery, and nine (17.2%) had prolonged or recurrent infection. Multivariate analysis demonstrated that significant risk factors for poor prognosis included a large intervertebral abscess cavity (P = 0.02) and multilevel intervertebral infections (P < 0.05). Conclusion: PEDI treatment is an effective, minimally invasive procedure for pyogenic spondylodiscitis. However, a large intervertebral abscess space could cause instability at the infected spinal column, leading to prolonged or recurrent infection after PEDI. In cases with a large abscess cavity with or without vertebral bone destruction, endoscopic drainage alone may have a poor prognosis, and spinal fixation surgery could be considered. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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