Abstract
Minimally invasive surgery is becoming popular for treating spinal disorders. The advantages of percutaneous endoscopic debridement and drainage (PEDD) for infectious spondylitis include direct observation of the lesion, direct pus drainage, and earlier pain relief. We retrospectively reviewed 37 patients who underwent PEDD and 31 who underwent traditional anterior open debridement and interbody fusion with bone grafting from 2004 to 2012. The causative organisms were isolated from 30 patients (81.1%) following PEDD, and from 25 patients (80.6%) following open surgery (p = 0.48). Staphylococcus aureus was the most common pathogen (38.2%). In the PEDD group, blood loss (<50 mL versus 585 ± 428 mL, p < 0.001) was significantly lesser and the duration of hospitalization (24.4 ± 12.5 days versus 31.5 ± 14.6 days, p = 0.03) was shorter than that in the open surgery group. Serologically, there were significantly faster C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) normalization rates in the PEDD group (p < 0.001, p = 0.009, respectively). In the two-year follow-up radiographs, 26 out of 30 (86.7%) open surgery patients showed bony fusions of the infected segments. On the contrary, sclerotic change of the destructive endplates was observed and the motion of infected spinal segments was still preserved in the PEDD group. There was no significant difference in the change of sagittal profile, including primary correction gain, correction loss, and actual correction gain/loss. PEDD is an effective alternative option and should be considered prior to traditional extensive spinal surgery—particularly for patients with early-stage spinal infection or serious complicated medical conditions.
Highlights
Spine infection accounts for about 2% to 4% of all bone infections [1]
The duration of hospitalization in the percutaneous endoscopic debridement and drainage (PEDD) group was shorter than the open group (24.4 ± 12.5 days versus 31.5 ± 14.6 days, p = 0.03)
For the patients who underwent PEDD, the time taken for C-reactive protein (CRP) to return to normal (
Summary
Spine infection accounts for about 2% to 4% of all bone infections [1]. The incidence of spinal infections has recently been increasing primarily due to prolonged life expectancy, improvements in diagnostic techniques, increasing iatrogenic spinal infections, intravenous drugs use, and the increased number of immunocompromised individuals. Conservative treatment, comprising of long-term antibiotics, bed rest, and external mechanical support is the treatment of choice for the majority of the patients. Additional surgery was required in 25% to 55% in these patients [3,4]. Surgical intervention must be considered in patients with significant bone destructions, mechanical instability or deformities, neurological impairments, epidural abscesses, failed conservative treatment or when biopsy data are needed [5,6,7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
