Surgical approach algorithm in the treatment of lumbar and thoracolumbar pyogenic spondylodiscitis
| Autor: | Cuneyt Sar, Murat Korkmaz, Turgut Akgül, Serkan Bayram, Fatih Dikici, Şahin Karalar |
|---|---|
| Přispěvatelé: | Acibadem University Dspace |
| Rok vydání: | 2021 |
| Předmět: |
Spondylodiscitis
Discitis Neurological function Pyogenic spondylodiscitis Lumbar Humans Medicine In patient Stage (cooking) Grading (tumors) Retrospective Studies Lumbar Vertebrae Surgical approach business.industry Surgical algorithm Functional status Middle Aged medicine.disease Spinal Fusion Treatment Outcome Debridement Surgery Neurology (clinical) business Algorithm Algorithms |
| Zdroj: | Turkish Neurosurgery. |
| ISSN: | 1019-5149 |
| DOI: | 10.5137/1019-5149.jtn.33784-21.2 |
| Popis: | AIM This study aimed to reveal the efficiency of our surgical approach algorithm in patients with thoracolumbar pyogenic spondylodiscitis based on the involvement of anatomical structure. MATERIAL AND METHODS Data of patients who underwent debridement or stabilization surgery for thoracolumbar pyogenic spondylodiscitis from January 2012 to December 2018 were reviewed. Lumbar and thoracolumbar spondylodiscitis was classified into four stages based on anatomical involvement. Infection was limited in the disc space, which had not spread to the endplate in stage 1 and progressed as two-level corpus involvement of 1/2 of vertebral corpus bony destruction or as failed treatment in stage 4. Neurological function was evaluated using Frankel's grading postoperatively. Functional outcomes were categorized according to the Kirkaldy-Willis criteria. RESULTS The study included 39 patients, with a mean age of 58.2 years. Of these patients, 10, 12, 13, and 4 had stages 1, 2, 3, and 4 spondylodiscitis, respectively. The mean follow-up period was 60.2 (12-184) months. All patients with stages 1 and 2 spondylodiscitis had grade E injury; 2 and 10 patients with stage 3 had grades D and E injuries, respectively; two patients with stage 4 had grade D injury and two had grade E injury at the last follow-up. Moreover, 100%, 84.6%, and 50% of the patients with stages 1 and 2, 3, and 4 spondylodiscitis achieved good or excellent results, respectively. CONCLUSION The choice of the surgical technique depends on the destruction severity at the adjacent vertebral corpus. Surgical staging system for spondylodiscitis is useful and reliable in choosing appropriate surgical techniques. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|