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Safety and efficacy of polyetheretherketone (PEEK) cages in combination with one-stage posterior debridement and instrumentation in Lumbar Brucella Spondylitis
Clinical Neurology and Neurosurgery ( IF 1.8 ) Pub Date : 2020-12-01 , DOI: 10.1016/j.clineuro.2020.106259
Rugang Zhao , Rui Ding , Qiang Zhang

OBJECTIVE The aim of this study was to explore the efficacy and safety of surgical treatment of lumbar brucella spondylitis with PEEK cages combined with one-stage posterior debridement and instrumentation. METHODS We performed a retrospective study for adult patients with lumbar brucella spondylitis. Medical records, imaging studies and laboratory data were collected, back pain was measured by employing the visual analog scale (VAS) and the neurological status was evaluated by using the American Spinal Injury Association (ASIA) scale. RESULTS A total of 61 consecutive patients (42 males and 19 females) were enrolled with the mean age at presentation of 56.33 ± 9.16 years old. L3-4 and L4-5 were the most infected levels with the ratios of 21.31 % and 19.67 % respectively. Moreover, 12 (19.67 %) patients suffered multiple-level infection and 5 (5/12, 41.67 %) of them had non-contiguous spondylitis. In addition, epidural masses were found in 26 (42.62 %) cases and psoas abscesses were found in 14 (22.95 %) cases. The number of operative segment depended on operation indications (failure of conservative measures, instability, kyphosis, intractable pain and/or neurological impairment). VAS scores were significantly improved at 6-weeks and the last follow-up. Among the 23 (37.70 %) patients with neurological deficits, 19 (19/23, 82.61 %) obtained a full recovery and 4 (4/23, 17.39 %) had been improved incompletely during the last follow-up. All patients exhibited satisfactory bone fusion during the last follow-up. Local infection of surgical site was identified in 6 (9.84 %) cases and no other surgery-related complications were found. CONCLUSION Use of PEEK cages for interbody fusion is feasible and safe in patients suffering from lumbar brucella spondylitis.

中文翻译:

聚醚醚酮 (PEEK) 笼子联合一期后路清创术和器械治疗腰布鲁氏菌脊柱炎的安全性和有效性

【摘要】:目的探讨PEEK椎间融合器联合一期后路清创内固定术治疗腰布鲁氏菌脊柱炎的疗效和安全性。方法我们对成年腰部布鲁氏菌脊柱炎患者进行了回顾性研究。收集医疗记录、影像学研究和实验室数据,使用视觉模拟量表(VAS)测量背痛,使用美国脊髓损伤协会(ASIA)量表评估神经状态。结果 共有 61 名连续患者(42 名男性和 19 名女性)入组,平均年龄为 56.33 ± 9.16 岁。L3-4 和 L4-5 是感染率最高的水平,分别为 21.31% 和 19.67%。此外,12 (19. 67 %) 患者出现多节段感染,其中 5 人 (5/12, 41.67 %) 患有非连续性脊柱炎。此外,在 26 例(42.62 %)病例中发现了硬膜外肿块,在 14 例(22.95 %)病例中发现了腰大肌脓肿。手术节段的数量取决于手术指征(保守措施失败、不稳定、脊柱后凸、顽固性疼痛和/或神经功能障碍)。VAS 评分在 6 周和最后一次随访时显着改善。23 例(37.70 %)神经功能缺损患者中,19 例(19/23,82.61 %)完全康复,4 例(4/23,17.39 %)在末次随访中未完全好转。所有患者在最后一次随访期间均表现出满意的骨融合。6 例(9.84 %)病例发现手术部位局部感染,未发现其他手术相关并发症。
更新日期:2020-12-01
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