Full Endoscopic Discectomy, Debridement, and Drainage for High-Risk Patients with Spondylodiscitis

Lin, Guang‐Xun; Kim, Jin-Sung; Sharma, Sagar; Sun, Liwei; Wu, Hsuan-Han; Chang, Kai-Sheng; Chen, Ying-Chieh; Chen, Chien‐Min

doi:10.1016/j.wneu.2019.02.206

Cited by 21 publications

(19 citation statements)

References 24 publications

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“…First of all, there is still no consensus on the optimal surgical strategy for PS [2]. Recently, the effectiveness of PPS fusion without anterior debridement is reported [11,12,18,19]; the effectiveness of intradiscal drainage with PEDD has been previously reported [2,4,5,[7][8][9][10]14,15,20]. There is a recent article reported successful case series treated by one-stage posterior fixation with anterior debridement from posterior approach [21].…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous drainage is a minimally invasive option [3]. Percutaneous endoscopic discectomy drainage (PEDD) is useful because it is minimally invasive and enables curettage of the infected area under visualization and simple puncture and drainage tube insertion [4][5][6][7][8][9][10]. Posterior percutaneous pedicle screw (PPS) fixation is a minimally invasive technique useful for infectious spinal conditions [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Secondary Infection/Microbial Substitution in a Managed Case of Pyogenic Spondylitis

Fujii¹,

Funayama²,

Li³

et al. 2021

Cureus

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Pyogenic spondylitis is a challenging condition that requires early and accurate diagnosis for appropriate treatment. Most cases can be treated non-surgically or with minimally invasive surgical procedures; however, a combination of anterior debridement/bone grafting and posterior fixation is necessary for severe cases. We encountered a case of lumbar pyogenic spondylitis treated with anterior debridement and autogenous bone grafting after percutaneous endoscopic discectomy drainage (PEDD) with percutaneous pedicle screw (PPS) fixation. The continuous pus oozing from the PEDD drainage tube wound was characteristic in this case, and the pus was considered to be caused by secondary infection/microbial substitution. The discharge immediately stopped and healed after anterior debridement and autogenous bone grafting. Escherichia coli was first detected as the causative bacterium, and Corynebacterium amycolatum and Corynebacterium striatum were detected as the cause of secondary infection/microbial substitution. The possibility of secondary infection/microbial substitution should be considered when the clinical course worsens.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Secondary Infection/Microbial Substitution in a Managed Case of Pyogenic Spondylitis

Fujii¹,

Funayama²,

Li³

et al. 2021

Cureus

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“…This might become a disadvantage as it may prevent acquiring a specific culture for the following target antibiotics. Lin et al 11 demonstrated a that the rate of cultured pathogens was 57% in 14 patients and Haaker et al 12 found a 45% culture rate in 16 patients; both these studies selected patients who underwent percutaneous endoscopic discectomy or drainage due to thoracic or lumbar spondylodiscitis. However, we could recognize the obvious pyogenic abscess via the endoscope.…”

Section: Discussionmentioning

confidence: 99%

Full Endoscopic Removal of Cervical Spinal Epidural Abscess: Case Report and Technical Note

et al. 2020

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Spinal epidural abscess is a rare disease that is less likely to occur in the cervical region. When it occurs here, cervical spondylodiscitis can develop. Surgical treatment is recommended because of possible life-threatening septic and neurological complications. We present a case of an 81-year-old man who suffered from right side paralysis and was subsequently diagnosed with a C4 to C7 epidural abscess. We utilized full endoscopic surgery for patient management. The traditional surgical methods for treating cervical epidural abscesses may cause spinal instability. There has only been one previous case report on the endoscopic-assisted method. Minimal invasive surgery by a full endoscopic method can be done with a small incision and is associated with minimal blood loss and muscle damage. This is the first report on cervical epidural abscess drainage utilization a full endoscopic method. We recommend this alternative minimally invasive method to manage cervical epidural abscess.

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“…Then, owing to the evolution of surgical equipment such as surgical drill and rongeur, the indication was enlarged to the decompression surgery for the spinal canal stenosis (30)(31)(32). Recently, the FESS was applied for debridement and drainage (FEDD) in patients with infectious discitis (13,14,33).…”

Section: Infectious Discitis and Full-endoscopic Debridementmentioning

confidence: 99%

“…If the infection is intractable, surgical management is indicated (12). The minimally invasive surgery would be percutaneous full-endoscopic debridement (13,14) ; however, there would be no report of percutaneous full-endoscopic endoscopic debridement for the intractable type 1 Modic change. Here, we describe the first case who underwent percutaneous full-endoscopic endoscopic debridement for the intractable type 1 Modic change.…”

Section: Introductionmentioning

confidence: 99%

A new surgical strategy for the intractable chronic low back pain due to type 1 Modic change using transforaminal full-endoscopic disc cleaning (FEDC) surgery under the local anesthesia : A case report and literature review

et al. 2021

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It has been reported that Modic change of the lumbar spine endplate includes three types: i.e. . edema or inflammation for type 1, fatty marrow change for type 2 and sclerotic change for type 3. Basically, type 1 Modic change may be related to the chronic low back pain. There are two kinds of the treatment for the type 1 Modic change to heal the pain : the anti-inflammatory drugs, and intra-discal injection of steroid. When the inflammatory change would be intractable, surgical intervention is needed. The gold standard for the surgical intervention is the segmental fusion of the affected level. The fusion surgery may cause the adjacent degeneration ; thus, motion preservation surgery is better, if possible. Our department started the motion preservation full-endoscopic intradiscal debridement surgery for this pathology, since some of the type 1 Modic change may be chronic discitis by P. Acnes. In this paper, we describe the first patient of type 1 Modic change who was successfully treated by the full-endoscopic intra-discal debridement and drainage under the local anesthesia. We named this procedure as transforaminal full-endoscopic disc cleaning surgery (FEDC). Finally, pathology, conservative and surgical intervention of Modic change was discussed.

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Full Endoscopic Discectomy, Debridement, and Drainage for High-Risk Patients with Spondylodiscitis

Cited by 21 publications

References 24 publications

Secondary Infection/Microbial Substitution in a Managed Case of Pyogenic Spondylitis

Secondary Infection/Microbial Substitution in a Managed Case of Pyogenic Spondylitis

Full Endoscopic Removal of Cervical Spinal Epidural Abscess: Case Report and Technical Note

A new surgical strategy for the intractable chronic low back pain due to type 1 Modic change using transforaminal full-endoscopic disc cleaning (FEDC) surgery under the local anesthesia : A case report and literature review

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