Posterior Titanium Screw Fixation without Debridement of Infected Tissue for the Treatment of Thoracolumbar Spontaneous Pyogenic Spondylodiscitis

Mauro Dobran; Maurizio Iacoangeli; Davide Nasi; Niccolo Nocchi; Alessandro Di Rienzo; Lucia di Somma; Roberto Colasanti; Carmela Vaira; Roberta Benigni; Valentina Liverotti; Massimo Scerrati

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저자정보: Mauro Dobran (Università Politecnica delle Marche) Maurizio Iacoangeli (Università Politecnica delle Marche) Davide Nasi (Università Politecnica delle Marche) Niccolo Nocchi (Università Politecnica delle Marche) Alessandro Di Rienzo (Università Politecnica delle Marche) Lucia di Somma (Università Politecnica delle Marche) Roberto Colasanti (Università Politecnica delle Marche) Carmela Vaira (Università Politecnica delle Marche) Roberta Benigni (Università Politecnica delle Marche) Valentina Liverotti (Università Politecnica delle Marche) Massimo Scerrati (Università Politecnica delle Marche)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.10 No.3

발행연도: 2016.1

수록면: 465 - 471 (7page)

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Study Design: Retrospective study. Purpose: The aim of our study was to analyze the safety and effectiveness of posterior pedicle screw fixation for treatment of pyogenic spondylodiscitis (PSD) without formal debridement of the infected tissue. Overview of Literature: Posterior titanium screw fixation without formal debridement of the infected tissue and anterior column reconstruction for the treatment of PSD is still controversial. Methods: From March 2008 to June 2013, 18 patients with PSD underwent posterior titanium fixation with or without decompression, according to their neurological deficit. Postero-lateral fusion with allograft transplantation alone or bone graft with both the allogenic bone and the autologous bone was also performed. The outcome was assessed using the visual analogue scale (VAS) for pain and the Frankel grading system for neurological status. Normalization both of C-reactive protein (CRP) and erythrocyte sedimentation rate was adopted as criterion for discontinuation of antibiotic therapy and infection healing. Segmental instability and fusion were also analyzed. Results: At the mean follow-up time of 30.16 months (range, 24–53 months), resolution of spinal infection was achieved in all patients. The mean CRP before surgery was 14.32±7.9 mg/dL, and at the final follow-up, the mean CRP decreased to 0.5±0.33 mg/ dL (p <0.005). Follow-up computed tomography scan at 12 months after surgery revealed solid fusion in all patients. The VAS before surgery was 9.16±1.29 and at the final follow-up, it improved to 1.38±2.03, which was statistically significant (p <0.05). Eleven patients out of eighteen (61.11%) with initial neurological impairment had an average improvement of 1.27 grades at the final follow-up documented with the Frankel grading system. Conclusions: Posterior screw fixation with titanium instrumentation was safe and effective in terms of stability and restoration of neurological impairment. Fixation also rapidly reduced back pain.

참고문헌 (1)

참고문헌 신청

Pramod Devkota / 2014 / Surgical Management of Pyogenic Discitis of Lumbar Region / Asian Spine Journal 8(2):177~182

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