Single-stage debridement via autogenous iliac bone graft through the OLIF corridor and lateral fixation in treating spontaneous single-level lumbar pyogenic spondylodiscitis

Wu, Songsong; Lin, Bin; Li, Xi; Chen, Shengkai; Zhang, Haonan; Wu, Zhanglin; Tang, Shenghui; Yang, Yueping; Liang, Biru

doi:10.1186/s12891-021-04815-3

Cited by 7 publications

(7 citation statements)

References 38 publications

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“…The prognosis of patients depends largely on the choice of materials for anterior cervical cage [ 9 ]. Autologous iliac bone (AIB), with a clinically recognized bone fusion rate, is the most commonly used material for reconstruction [ 10 ]. However, AIB is not suitable for short-track speed skaters who need to perform high-intensity training and exercise after rehabilitation due to its low strength to provide insufficient support, inclination to absorption and subsidence, and the risk of infection at the donor site [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of NHP66 Bioactive Cage on Patients with Cervical Spine Injury in Short-Track Speed Skating

Yang

Liu

Yin

et al. 2022

Computational and Mathematical Methods in Medicine

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Background. Short-track speed skating (STSS) is an extreme sport in pursuit of extreme speed and explosive force. In such a sport, once athletes fall down, they are susceptible to serious cervical spine injury (CSI) under the inertia of high-velocity movement. Nanohydroxyapatite/polyamide 66 (NHP66) bioactive cage is a high-tech product of nanotechnology in the medical field in recent years. With a structure similar to that of human cortical bone, NHP66 bioactive cage has extremely high toughness and strength, which tailors to the needs of STSS. Objective. This study mainly analyzed the therapeutic effect of NHP66 on patients with CSI in STSS, aiming to provide new opportunities for the treatment of this patient population. Methods. A total of 51 patients with CSI treated in our hospital were enrolled, including 19 cases of short-track speed skaters (observation group) and 32 cases of car accidents, falls from heights, or collision injuries (control group). The relevant surgical indicators (operation time, intraoperative blood loss, etc.), the incidence of adverse reactions, the Cobb angle of cervical lordosis before and after surgery, and the fusion segment height of the cage were observed and compared between the two groups. Postoperative pain was evaluated by the visual analog scale (VAS), improvement of spinal cord injury was assessed by the American Spinal Cord Injury Association (ASIA) Impairment Scale, and bone fusion, bone subsidence, and other motor functions were assessed by the Japanese Orthopaedic Association (JOA) score rating system. Results. The operation time, intraoperative blood loss, and incidence of adverse reactions in the observation group were significantly lower than those in the control group. The Cobb angle of cervical lordosis and the fusion segment height of cage increased significantly higher in both groups after surgery. In addition, the VAS scores of the observation group 2 h and 3 d after operation were significantly lower than those of the control group. In terms of improvement of spinal cord injury, ASIA and JOA scores in the observation group were significantly higher than those before treatment and in the control group. There was no significant difference in bone fusion activity between the two groups. Conclusions. In this study, it is found through experiments that NHP66 has higher safety and application value than autogenous iliac bone, confirming that NHP66 can achieve significant results as a cage for anterior cervical decompression and iliac bone graft fusion and internal fixation in short-track speed skaters after CSI.

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Section: Introductionmentioning

confidence: 99%

Efficacy of NHP66 Bioactive Cage on Patients with Cervical Spine Injury in Short-Track Speed Skating

Yang

Liu

Yin

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Pyogenic spondylodiscitis affected the Th12/L1, L3/L4, and L4/L5 levels, at which debridement and fixation were performed using OLIF. Although the efficacy of oblique intervertebral lumbar fusion has been previously reported [ 10 , 11 ], this method has been applied only to single-level lesions. Our case is unique in that we performed OLIF for multi-level lesions.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to these conventional approaches, following technological advancements, minimally invasive surgery via the posterior approach using percutaneous pedicle screws (PPSs) has been reported to be safe and effective for pyogenic spondylitis and spondylodiscitis [8,9]. The effectiveness of oblique lumbar intervertebral fixation (OLIF) for thoracic and lumbar pyogenic spondylodiscitis has also been described [10,11]. In previous studies, this novel approach has been performed at only a single or limited level [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Two-Stage Cervical and Thoracic-Lumbar-Sacral Circumferential Fixation for Pyogenic Spondylitis: A Case Report

Maki,

Fukaya

2024

Cureus

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Pyogenic spondylitis is a rare life-threatening condition. Conservative treatment with antibiotics is indicated; however, surgery can be considered in refractory cases. The surgical strategy varies, as pyogenic spondylosis can occur from the cervical to sacral regions. To our knowledge, although there is less invasiveness as an advantage in the following management, cervical and thoracic-lumbar-sacral circumferential fixations in two sessions for pyogenic spondylitis have not been previously described. An 84-year-old man complained of ambulation disturbances and pain in the neck and upper and lower extremities (the Japan Orthopaedic Association cervical myelopathy evaluation questionnaire score of 5/17). Magnetic resonance imaging revealed pyogenic spondylitis of the cervical, thoracic, and lumbar regions. Epidural abscesses and spondylodiscitis were concurrently diagnosed with multi-level skipping lesions from the cervical to the sacral regions. As these lesions were resistant to antibiotic treatment and the neurological symptoms worsened, surgical treatment was planned. Anterior cervical discectomy and fusion, and posterior cervical fixation were followed by oblique and posterior lumbar intervertebral fusions with long-level fixation from T12 to the ilium using percutaneous pedicle screws. The surgeries were performed in two sessions to avoid the invasiveness of surgeries in a single session. The patient’s condition improved after a second surgery. The patient was discharged on postoperative day 116. No recurrence was observed for six months, and the patient was able to ambulate independently. Two-stage cervical and thoracic-lumbar-sacral circumferential fixation for pyogenic spondylitis contributed to a favorable outcome (the Japan Orthopaedic Association cervical myelopathy evaluation questionnaire score of 13/17).

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“…Classical lateral‐only instrumentation in the OLIF‐LF group was performed according to studies, 11 with entry points located at the center of the vertebrae and trajectories vertical to the sagittal plane (Figure 1A,C ). In contrast, the instrumentation in the OLIF‐RLPS group was performed with modified entry points (Figure 1B ) and adjusted trajectories (Figure 1D ).…”

Section: Methodsmentioning

confidence: 99%

Reverse Lumbar Pedicle Screw in Oblique Lateral Interbody Fusion: A Novel Concept to Restrict Cage Subsidence

He,

Luo,

Fang

et al. 2023

Orthopaedic Surgery

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ObjectiveCage subsidence is a common morbidity after oblique lumbar interbody fusion (OLIF), with risk of compromising clinical and radiographic outcomes. The study aims to describe an innovative reverse lumbar pedicle screw (RLPS) technique in OLIF and compare its effect on restricting cage subsidence with classical lateral fixation (LF) in radiological and clinical evaluation.MethodConsecutive patients having undergone single‐level OLIF‐LF/RLPS from 2018 to 2020 were retrospectively reviewed. In OLIF‐RLPS, the upper entry point was determined at the intersection between one horizontal line (1 cm above inferior endplate) and one vertical line (dissecting anterior and middle thirds of the vertebra) while the inferior entry point between one horizontal line (5 mm below superior endplate) and the same vertical line. Trajectories were from vertebrae reverse into contralateral pedicle. Radiological evaluation included disc height (DH) and segmental lordosis (SL); cage subsidence was evaluated by DH loss. Clinical assessment included visual analogue scale (VAS) and Oswestry disability index (ODI). Student t or Mann–Whitney U test was used for continuous variation according to normality analysis while Chi‐square test for category variation.ResultsA total of 29 patients had been enrolled in the study including 14 cases in the RLPS group and 15 cases in the LF group. The DH in the OLIF‐RLPS group had increased from the preoperative 9.07 ± 1.73 mm to 13.73 ± 1.83 mm postoperatively, without significant difference compared with the OLIF‐LF group during the perioperative, but decreased to 12.53 ± 1.74 mm in 3 months and maintained at 12.00 ± 1.45 mm in 12 months, significantly higher than the OLIF‐LF group (p < 0.05). At the last follow‐up, 7.1% (1/14) cases in the OLIF‐RLPS group had shown subsidence of grade I, significantly less than 46.7% (7/15) cases in the OLIF‐LF group. Pain and disability had improved similarly in two groups, without significant difference detected between two groups at the last follow‐up.ConclusionRLPS technique with modified entry points and prolonged trajectory could effectively restrict cage subsidence in OLIF postoperatively compared with traditional lateral fixation.

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Single-stage debridement via autogenous iliac bone graft through the OLIF corridor and lateral fixation in treating spontaneous single-level lumbar pyogenic spondylodiscitis

Cited by 7 publications

References 38 publications

Efficacy of NHP66 Bioactive Cage on Patients with Cervical Spine Injury in Short-Track Speed Skating

Efficacy of NHP66 Bioactive Cage on Patients with Cervical Spine Injury in Short-Track Speed Skating

Two-Stage Cervical and Thoracic-Lumbar-Sacral Circumferential Fixation for Pyogenic Spondylitis: A Case Report

Reverse Lumbar Pedicle Screw in Oblique Lateral Interbody Fusion: A Novel Concept to Restrict Cage Subsidence

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