One-stage surgical management for lumber brucella spondylitis with anterior debridement, autogenous graft, and instrumentation

Yin, Xin; Liu, Zhong Kai; He, Bao Rong; Hao, Ding Jun

doi:10.1097/md.0000000000011704

Cited by 18 publications

(14 citation statements)

References 30 publications

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“…Clinically, various surgical methods for brucella spondylitis include anterior, posterior, or anterior and posterior debridement for bone graft fusion, and minimally invasive surgical methods, which emerged in recent years [7,16,17,19,20]. The traditional surgical methods of brucella spondylitis are anterior and posterior combined debridement, bone graft fusion, and instrumentation.…”

Section: Discussionmentioning

confidence: 99%

Beneficial influence of single-stage posterior surgery for the treatment of lumbar brucella spondylitis combined with spondylolisthesis

Zhang

Zhao

Chen

et al. 2022

Preprint

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We aimed to evaluate the clinical efficacy of the single-stage posterior surgical treatment for patients of lumbar brucella spondylitis combined with spondylolisthesis. In this study, we performed a retrospective analysis of 16 patients with lumbar brucellosis spondylitis combined with spondylolisthesis from January 2015 to January 2019. All patients underwent single-stage posterior lumbar debridement, reduction, interbody fusion, and instrumentation. Preoperative and postoperative of the visual analog scale (VAS), the Japanese orthopedic association scores (JOA), the Oswestry disability index (ODI), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were compared. In addition, the spondylolisthesis reduction rate, reduction loss rate, interbody fusion rate, and complication rate were recorded. VAS, JOA, ODI, ESR, and CRP were conducted with repeated analysis of variance data at different follow-ups. The postoperative follow-up was 12 to 36 months, with an average of (25.0±8.1) months. VAS, JOA, ODI, ESR, and CRP were significantly better at two-week and one-year follow-up than preoperative results (P=0.000, respectively). In addition, one year after the operation, VAS, JOA, ODI, ESR, and CRP showed a significant improvement (P=0.000, respectively). The average spondylolisthesis reduction in two weeks after operation was (91.2±6.7) %, and the median reduction loss rate in one year after operation was 8.0 (5.0,9.8) %. At the last follow-up, all patients achieved interbody fusion, no loosening and fracture of instrumentation were found, and no recurrence happened. Single-stage posterior operation for lumbar debridement, reduction, interbody fusion, and instrumentation is beneficial for treating lumbar brucellosis spondylitis combined with spondylolisthesis. Furthermore, the reconstruction of spinal stability may relieve pain, heal lesions, and improve patients’ living.

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Section: Discussionmentioning

confidence: 99%

Beneficial influence of single-stage posterior surgery for the treatment of lumbar brucella spondylitis combined with spondylolisthesis

Zhang

Zhao

Chen

et al. 2022

Preprint

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“…In further research, we may be able to perform correlation studies. Clinically, various surgical methods for brucella spondylitis include anterior, posterior, or anterior and posterior debridement for bone graft fusion, and minimally invasive surgical methods, which emerged in recent years 8,16,17,19,20 . The traditional surgical methods of brucella spondylitis are anterior and posterior combined debridement, bone graft fusion, and instrumentation.…”

Section: Discussionmentioning

confidence: 99%

Beneficial influence of single-stage posterior surgery for the treatment of lumbar brucella spondylitis combined with spondylolisthesis

Zhang

Zhao

Chen

et al. 2022

Sci Rep

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We aimed to evaluate the clinical efficacy of the single-stage posterior surgical treatment for patients of lumbar brucella spondylitis combined with spondylolisthesis. In this study, we performed a retrospective analysis of 16 patients with lumbar brucellosis spondylitis combined with spondylolisthesis from January 2015 to January 2019. All patients underwent single-stage posterior lumbar debridement, reduction, interbody fusion, and instrumentation. Preoperative and postoperative of the visual analog scale (VAS), the Oswestry disability index (ODI), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were compared. In addition, the spondylolisthesis reduction rate, reduction loss rate, interbody fusion rate, and complication rate were recorded. VAS, ODI, ESR, and CRP were conducted with repeated analysis of variance data at different follow-ups. The postoperative follow-up was 12–36 months, with an average of (25.0 ± 8.1) months. VAS, ODI, ESR, and CRP were significantly better at 2-week and 1-year follow-up than preoperative results (P = 0.000, respectively). In addition, 1 year after the operation, VAS, ODI, ESR, and CRP showed a significant improvement (P = 0.000, respectively). The average spondylolisthesis reduction in 2 weeks after operation was (91.2 ± 6.7)%, and the median reduction loss rate in 1 year after operation was 8.0 (5.0, 9.8)%. At the last follow-up, all patients achieved interbody fusion, no loosening and fracture of instrumentation were found, and no recurrence happened. Single-stage posterior operation for lumbar debridement, reduction, interbody fusion, and instrumentation is beneficial for treating lumbar brucellosis spondylitis combined with spondylolisthesis. Furthermore, the reconstruction of spinal stability may relieve pain, heal lesions, and improve patients’ living.

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“…Debridement and reconstruction are two main principles of the surgical treatment of pyogenic spondylitis [23,24]. The anterior approach provides direct visualization for radical debridement and decompression without affecting the posterior elements,which is the best way to control the infection and promote de nitive healing, and it also can warrant adequate and strong reconstruction with modern instrumentation tools [10][11][12]. However, anterior surgery alone does not adequately correct kyphosis and could not bear physiological loads, the recurrence of kyphosis following it are di cult to treat [9,25].…”

Section: Discussionmentioning

confidence: 99%

“…Anterior, posterior and combined approaches have been used for the treatment of spondylodiscitis [9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Combination Use of Antibiotic-Loaded Calcium Sulfate Beads in Spinal Surgery for Patients with Spondylodiscitis：A Clinical Retrospective Study

Tang¹,

Li²,

Wang³

et al. 2021

Preprint

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Background. Various surgical techniques for treating spondylodiscitis have been proposed, but the optimal surgical treatment remains controversial. In this study, we propose a new procedure that is implanting antibiotic-loaded calcium sulfate (CS) beads into the disc after infection site debrided by Quadrant channel combined with percutaneous fixation through a single-stage posterior approach for the treatment of spondylodiscitis. Thus, the purpose of this study is to assess the safety and efficacy of this procedure. Methods. This study collected 32 patients’ clinical data of whom had spine spondylodiscitis treated in our department from July of 2015 to August of 2020. The Demographic data included age, gender, involved segment and complications were collected. The intra-operative details, results of culture, functional outcome, radiologic outcome, and length of hospital stay, laboratory examination were recorded. Results. The mean age of the 32 patients was 61.1 ± 9.7 years old. The mean operative time was 135.0 ± 30.6 minutes, and the mean blood loss was 243.4 ± 92.1 ml. The positive rate of culture was 72%. The mean Visual analogue scale (VAS) and Oswestry Disability Index (ODI) score significantly improved from 7.5 to 1.6 and from 65–10%. Cobb angle was significantly improved and could be maintained at final follow-up. Solid bone fusion was achieved in all patients. There were no recurrences of infection in our study. Conclusions. The procedure we proposed is effective in the treatment of spondylodiscitis, the infection site can be debrided and controlled exactly, and spinal stabilization can also be achieved.

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One-stage surgical management for lumber brucella spondylitis with anterior debridement, autogenous graft, and instrumentation

Cited by 18 publications

References 30 publications

Beneficial influence of single-stage posterior surgery for the treatment of lumbar brucella spondylitis combined with spondylolisthesis

Beneficial influence of single-stage posterior surgery for the treatment of lumbar brucella spondylitis combined with spondylolisthesis

Beneficial influence of single-stage posterior surgery for the treatment of lumbar brucella spondylitis combined with spondylolisthesis

Combination Use of Antibiotic-Loaded Calcium Sulfate Beads in Spinal Surgery for Patients with Spondylodiscitis：A Clinical Retrospective Study

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