One-stage oblique lateral corridor antibiotic-cement reconstruction for Candida spondylodiscitis in patients with major comorbidities: Preliminary experience
| Autor: | Daniel Shedid, M. Mc Graw, Van Tri Truong, Zhi Wang, Ghassan Boubez, Nicholas M. Newman |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Spondylodiscitis
Male medicine.medical_specialty Discitis medicine.medical_treatment Comorbidity Oblique lateral 03 medical and health sciences 0302 clinical medicine Lumbar Candida albicans medicine Humans Aged Retrospective Studies Debridement Lumbar Vertebrae biology business.industry Bone Cements Candidiasis Perioperative Middle Aged medicine.disease biology.organism_classification Surgery Anti-Bacterial Agents Treatment Outcome 030220 oncology & carcinogenesis Radiological weapon Intractable pain Female Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Neuro-Chirurgie. 67(2) |
| ISSN: | 1773-0619 |
| Popis: | Fungal spondylodiscitis is rare (0.5%–1.6% of spondylodiscitis) and mainly caused by Candida albicans. Surgical intervention in spondylodiscitis patients is indicated for compression of neural elements, spinal instability, severe kyphosis, failure of conservative management and intractable pain. However, there is no evidence-based optimal surgical approach for spondylodiscitis. There have been only case reports of surgical treatment for Candida spondylodiscitis. We evaluated the preliminary results of the efficacy and safety of one-stage debridement via oblique lateral corridor with interbody fusion (OLIF) using stand-alone cement reconstruction after debridement for the treatment of Candida spondylodiscitis in patients with major co-morbidities. Five patients (4 males, 1 female, mean age: 64.2 years) suffering from Candida albicans lumbar spondylodiscitis who underwent this procedure were studied. Their predominant symptoms were unremitting back and leg pain and all had pre and postoperative anti-fungal therapy under microbiologist supervision. The operative time ranged from 137 minutes to 260 minutes (mean: 213.4 minutes). The mean blood loss was 160 mL (range: 100–200 mL). There were no perioperative complications. At follow-up all showed major improvement in pain and ambulatory status. CT scan showed radiological stability for all patients at 6–12 months. Our preliminary results showed stand-alone anterior debridement and spinal re-construction with cement through mini-open OLIF approach might be a safe and effective option for patients with spinal fungal infection and major comorbidities. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect