Minimally Invasive Surgery Oblique Lumbar Interbody Debridement and Fusion for the Treatment of Lumbar Spondylodiscitis

Autor: Bingjin Wang, Chao Chen, Wenbin Hua, Wencan Ke, Saideng Lu, Yukun Zhang, Xianlin Zeng, Cao Yang
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Orthopaedic Surgery, Vol 12, Iss 4, Pp 1120-1130 (2020)
Druh dokumentu: article
ISSN: 1757-7861
1757-7853
DOI: 10.1111/os.12711
Popis: Objective To evaluate the efficacy and feasibility of minimally invasive oblique lumbar interbody debridement and fusion for the treatment of conservatively ineffective lumbar spondylodiscitis. Methods This is a retrospective study. Between December 2016 and November 2017, a total of 14 consecutive patients (eight males and six females, with an average age of 49.1 years, range from 42 to 74 years) with single‐level lumbar spondylodiscitis were included in the study. The inclusion criteria include single‐level spondylodiscitis without spinal deformity or epidural abscess, ineffective conservative treatment (continuously aggravated clinical symptoms and uncontrollable infective symptoms treated with antibiotics for more than 6 weeks), minimally invasive oblique lumbar interbody fusion surgery (Mis‐OLIF) and iliac graft for the treatment of lumbar spondylodiscitis, and postoperative follow‐up >12 months. Each patient was treated Mis‐OLIF. Clinical outcomes including demographic characteristics, erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), visual analog scale (VAS), the Oswestry Disability Index (ODI), American Spinal Injury Association neurological classification, and lordotic angle were analyzed. Results The infectious levels included L1/2 (one patient), L2/3 (two patients), L3/4 (eight patients), and L4/5 (three patients). The pathogens found in these patients included Staphylococcus aureus (5), brucellosis (6), and enterobacterium (2). The pathogen was undefined in one patient. The mean duration of the surgery, mean blood loss, and mean follow‐up were 89.3 ± 17.5 min, 155.0 ± 49.4 mL, and 16.8 ± 4.2 months, respectively. The ESR and CRP decreased after Mis‐OLIF and antibiotic administration. The average preoperative VAS score was 6.9 ± 0.9, then decreased to 3.0 ± 1.0 (t = 14.18, P
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