One-stage Combined Surgery with Mesh Cages for Treatment of Septic Spondylitis
| Autor: | Georgios Petsinis, Georgios Koureas, Panagiotis Iliopoulos, Spyridon Zacharatos, Panagiotis Korovessis |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Bone Screws Kyphosis Lumbar Sepsis medicine Humans Orthopedics and Sports Medicine Spondylitis Aged Retrospective Studies Aged 80 and over Titanium business.industry Osteomyelitis Retrospective cohort study General Medicine Middle Aged Staphylococcal Infections Surgical Mesh medicine.disease Surgery Spinal Fusion Treatment Outcome Surgical mesh Debridement Orthopedic surgery Female Intractable pain Gram-Negative Bacterial Infections business |
| Zdroj: | Clinical Orthopaedics & Related Research. 444:51-59 |
| ISSN: | 0009-921X |
| DOI: | 10.1097/01.blo.0000203449.51769.7f |
| Popis: | UNLABELLED There is a controversy regarding most effective operative method for treatment of pyogenic spondylitis and whether to use metallic implants on the site of infection. This retrospective study reports on the outcome of 17 patients with persistent cervical and lumbar pyogenic spondylitis who had one-stage combined surgery and fusion with use of a titanium mesh cage for intractable pain, kyphosis, and neurologic impairment. All patients tolerated the combined operation and were followed up on for 45 months. Incomplete neurologic lesions improved postoperatively an average 1.4 Frankel grades. Visual analog pain score (mean) improved from 7 preoperatively to 2 postoperatively. Average correction of local kyphotic deformity was 6 degrees without loss of correction at final observation. There was no expulsion or migration of any titanium mesh cage or loosening of the posterior instrumentation. There was an approach-related abdominal hernia after wound infection. At the final followup, the combined operation in combination with the use of the mesh cage improved sagittal alignment and resulted in eradication of the infection and attainment of solid fusion. The presence of the titanium mesh cage anteriorly at the site of infection had no adverse effect on the course of infection. Patients with cervical and lumbar osteomyelitis can successfully have instrumented-combined, one-stage surgery. LEVEL OF EVIDENCE Prognostic study, Level II (retrospective study). Please see the Guidelines for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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