中国组织工程研究2019，Vol.23Issue(14)：2133-2139,7.DOI:10.3969/j.issn.2095-4344.1662
抗生素人工骨植入治疗化脓性椎间盘炎
Antibiotic artificial bone implantation for treating pyogenic spondylodiscitis
摘要
Abstract
BACKGROUND: There is no report on the treatment of suppurative discitis with posterior microendoscopic discectomy, antibiotic artificial bone implantation and one-stage percutaneous pedicle screw fixation. OBJECTIVE: To evaluate the clinical effectiveness of posterior microendoscopic debridement, antibiotic artificial bone implantation and one-stage percutaneous pedicle screw fixation for pyogenic spondylodiscitis. METHODS: Thirty-one patients with suppurative discitis admitted at the Department of Spinal Surgery, the First Affiliated Hospital of Guangzhou Medical University from January 2014 to December 2017, including 17 males and 14 females, aged 28-78 years, were included. All the patients underwent posterior microendoscopic lesion clearance and antibiotic artificial bone grafting and one-stage percutaneous pedicle screw fixation. The erythrocyte sedimentation rate and C-reactive protein levels were detected at postoperative follow-up. The Visual Analog Scale and the Japanese Orthopaedic Association scores were used for detection. RESULTS AND CONCLUSION: (1) All the surgical operations of the 31 patients were successfully completed and all patients had immediate relief of low back pain and lower extremity radiation pain. They were able to move ground wearing a waistband at 1-4 days postoperatively. (2) Thirty-one patients were followed up for 9-18 months. All patients had a significant decrease in C-reactive protein and erythrocyte sedimentation rate at 1 week after surgery, and C-reactive protein and erythrocyte sedimentation rate were in the normal range at 1, 3, and 6 months postoperatively. (3) The Visual Analog Scale scores of all patients at 1 week of follow-up were significantly lower than those before surgery (P < 0.05) , and the Japanese Orthopaedic Association scores were significantly higher than those before surgery (P < 0.05) . (4) In the follow-up examination of CT and MRI, there was no recurrence, pseudoarticular formation or internal fixation loosening. (5) These results suggest that posterior microendoscopic discectomy, antibiotic artificial bone implantation combined with one-stage percutaneous pedicle screw fixation for treating suppurative discitis can result in little trauma, few bleeding and rapid pain relief, and patients can move to the ground early. The operation method has a good clinical effect.关键词
化脓性椎间盘炎/内固定/椎间盘镜/微创手术/病灶清除/抗生素人工骨/椎弓根螺钉/脊柱稳定性/快速康复Key words
Internal Fixators/Discitis/Surgical Procedures, Minimally Invasive/Tissue Engineering分类
医药卫生引用本文复制引用
姚立权,凌钦杰,李家颖,钟乐天,周兴平,刘锦滔,何二兴,尹知训..抗生素人工骨植入治疗化脓性椎间盘炎[J].中国组织工程研究,2019,23(14):2133-2139,7.基金项目
广东省科技厅科技计划项目(2014A020212369),项目负责人:尹知训 （2014A020212369）
广州市科信局应用基础项目(2013J4100041),项目负责人:尹知训 （2013J4100041）
