Percutaneous Suction Aspiration and Drainage for Pyogenic Spondylitis

Nagata, Kensei; Ohashi, Takuma; Ariyoshi, Mamoru; Sonoda, Kyosuke; Imoto, Hiroki; Inoue, Akio

doi:10.1097/00007632-199807150-00018

Cited by 45 publications

(35 citation statements)

References 10 publications

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“…Based on these previous findings, Nagata (co-author of this paper) and his coworkers [13] began to apply percutaneous suction aspiration and drainage for the treatment of pyogenic spondylitis. In 1998, they reported the use of continuous drainage and intermittent local administration of antibiotics in addition to percutaneous suction aspiration in 23 patients with pyogenic spondylitis.…”

Section: Discussionmentioning

confidence: 98%

Surgical Results of Percutaneous Suction Aspiration and Drainage for Pyogenic Spondylitis

et al. 2010

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Summary:Forty patients (24 male and 16 female; age 13-87 years, mean 66 years) with pyogenic spondylitis were treated by percutaneous suction aspiration and drainage between January 1997 and September 2007 at Kurume University Hospital. The surgical procedure and transpedicular approach were similar to those used for percutaneous discectomy in the treatment of intervertebral disc herniation. The average postoperative follow-up period was 22.6 months. Two patients had died by the time of the survey, and two had undergone multiple operations. The clinical outcomes were excellent in 12 patients, good in 17 patients, fair in 5 patients, and poor in 6 patients. The response rate (cases with "excellent" or "good" outcomes) was 72.5% (29 patients). Identification of the organism was possible in 26 patients (65%). The most frequently identified organism was methicillinresistant Staphylococcus aureus (MRSA; 11 cases), followed by methicillin-sensitive Staphylococcus aureus (MSSA; 5 cases) and Escherichia coli (3 cases). Percutaneous suction aspiration and drainage has been demonstrated as an effective means of treating early spondylitis. This procedure is minimally invasive and enables pathogen identification, histopathological diagnosis and even simultaneous treatment. This is the only means of treatment available for patients who cannot tolerate open surgery. This therapy also promises medico-economic advantages by shortening treatment periods and eliminating open surgery.

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Section: Discussionmentioning

confidence: 98%

Surgical Results of Percutaneous Suction Aspiration and Drainage for Pyogenic Spondylitis

et al. 2010

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“…Such medical treatment is generally effective. [7][8][9][10] However, surgical treatment should be considered in a patient with neurological deficits, extensive collapse of the vertebral bodies, or persistent infection in spite of antifungal chemotherapy. 1,11) Furthermore, radical surgery for the infectious lesions is necessary in an immunocompromised host, such as a patient requiring extensive chemotherapy to control malignant tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Antifungal chemotherapy is the first choice, and such medical treatment is generally effective. [7][8][9][10] We treated a patient developed thoracolumbar spondylodiscitis due to C. albicans during repeated systemic chemotherapy for cerebellar medulloblastoma. Long-term antifungal medical therapy was not effective, so we performed radical surgery of total corpectomy of the infected vertebral bodies with anterior autologous bone grafting.…”

Section: Introductionmentioning

confidence: 99%

Surgical Strategy for Spondylodiscitis Due to Candida Albicans in an Immunocompromised Host. Case Report.

Tokuyama

Nishizawa

Yokota

et al. 2002

Neurol. Med. Chir.(Tokyo)

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A 44-year-old woman receiving systemic chemotherapy for cerebellar medulloblastoma developed thoracolumbar spondylodiscitis due to Candida albicans associated with abscesses in the bilateral psoas muscles. As long-term medical therapy with fluconazole was not effective, radical removal of the affected lesions and anterior bone grafting were performed. Corpectomy of the infected vertebra with autologous bone grafting and removal of the psoas muscle were performed via the right transthoracic retroperitoneal approach. Additional posterior instrumentation was not used. Two years after the operation, the patient was doing well, and systemic chemotherapy for medulloblastoma has restarted. Corpectomy with radical resection of surrounding infectious tissues for C. albicans spondylodiscitis in an immunocompromised host should be performed when conservative medical treatment is not successful. Further instrumentation surgery might be necessary to prevent further deformity of the spine as the second surgery.

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“…[27,28] Similarly, several minimally invasive spinal techniques had been developed and used to treat infectious spondylodiscitis. [29][30][31][32][33][34][35][36][37] CT-guided percutaneous catheter drainage, [19] percutaneous transpedicular discectomy and drainage, [29,32] percutaneous drainage and continuous irrigation, [33,36] percutaneous suction aspiration and drainage, [34,37] and automated percutaneous flexible nucleotome debridement [30,35] through a unilateral or bilateral posterolateral approach have been reported as efficient and safe procedures in the management of early-stage spondylodiscitis. However, these procedures lack intraoperative virtual images monitoring for debridement of the lesion site.…”

Section: Minimally Invasive Spinal Surgery For Spondylodiscitismentioning

confidence: 99%

Minimally invasive percutaneous endoscopic discectomy and drainage for infectious spondylodiscitis

Fu¹,

Chen²,

Chen³

2013

Biomed J

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The primary goals for treating infectious spondylodiscitis are to make an accurate diagnosis, isolate the causative organism, and prescribe effective antibiotic therapy based on the culture data. A positive culture of the responsible organism is not required for diagnosis, although it is extremely important for successful treatment and prevention of further morbidity. Surgical intervention is usually reserved for cases that are unresponsive to antibiotic therapy and for patients who have developed progressive spinal deformity or instability, epidural abscesses, or neurological impairment. However, the incidence of perioperative morbidity is particularly increased in elderly patients or in those with poor general condition. With improved endoscopic instruments and techniques, our clinical experiences demonstrate that spinal infections can be successfully treated by minimally invasive percutaneous endoscopic debridement. Direct endoscopic observation and collection of sufficient quantities of samples for microbiological examinations from the infected region are usually possible. This article summarizes the diagnostic and therapeutic values of percutaneous endoscopic discectomy and drainage (PEDD) used to treat patients with spondylodiscitis. Our clinical evidence-based survey suggests that PEDD can provide adequate retrieval of specimens and has high diagnostic efficacy, thereby enabling prompt and sensitive antibiotic therapy to the offending pathogens. We propose that PEDD is an effective alternative for treating infectious spondylodiscitis and should be considered prior to extensive anterior surgery in selected cases. This method is particularly suitable for patients with early-stage spinal infection or serious medical conditions. (Biomed J 2013;36:168-174)

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Percutaneous Suction Aspiration and Drainage for Pyogenic Spondylitis

Abstract: Evaluation of percutaneous suction aspiration with drainage shows that it is an effective treatment for early-stage pyogenic spondylitis.

Cited by 45 publications

References 10 publications

Surgical Results of Percutaneous Suction Aspiration and Drainage for Pyogenic Spondylitis

Surgical Results of Percutaneous Suction Aspiration and Drainage for Pyogenic Spondylitis

Surgical Strategy for Spondylodiscitis Due to Candida Albicans in an Immunocompromised Host. Case Report.

Minimally invasive percutaneous endoscopic discectomy and drainage for infectious spondylodiscitis

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