The Analysis of the Therapeutic Effect of Intervertebral Foramen Endoscopy on Single Segment Non-specific Lumbar Intervertebral Space Infection

You LI; Heng DING; Liang CUI; Yuanxi ZHAO; Enyu ZHAN; Xingguo LI

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You LI, Heng DING, Liang CUI, Yuanxi ZHAO, Enyu ZHAN, Xingguo LI. The Analysis of the Therapeutic Effect of Intervertebral Foramen Endoscopy on Single Segment Non-specific Lumbar Intervertebral Space Infection[J]. Journal of Kunming Medical University.

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The Analysis of the Therapeutic Effect of Intervertebral Foramen Endoscopy on Single Segment Non-specific Lumbar Intervertebral Space Infection

Dept. of Orthopaedics，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2024-01-11
Available Online: 2024-04-29

Abstract

Abstract

Objective To evaluate the efficiency of posterolateral approach in the treatment of single-segment nonspecific lumbar spondylodiscitis by observation of the clinical results of posterior lateral percutaneous transforaminal endoscopic debridement （PTED） approach and posterior single segmental lumbar debridement, bone graft and internal fixation in the treatment of single segment nonspecific lumbar spondylodiscitis. Methods In this study, 42 patients （ males 24 and females 18 with an average age of 54 years） with nonspecific lumbar spondylodiscitis treated in the Department of Orthopaedics of the 1st Affiliated Hospital of Kunming Medical University from June 2016 to June 2023 were analyzed retrospectively. They were divided into group A （n = 21） and group B （n = 21）. All the patients in group A were treated with posterolateral percutaneous transforaminal endoscopic debridement combined with soft tissue immersion to improve the detection rate of etiology. All the patients in group B were treated with posterior single-segment lumbar focus debridement, bone graft and internal fixation. The visual analogue scale score of low back pain （VAS）, Japanese Orthopaedic Association Lumbar vertebra score （JOA） and lumbar vertebra ODI scale were compared before and after the operation to evaluate the remission of clinical symptoms, infection indexes such as white blood cells, hypersensitive C-reactive protein, ESR, the therapeutic effect of pathogenic drug-resistant bacteria, bacterial culture rate and postoperative complications. Results The positive rate of pathogen culture obtained through posterior lateral percutaneous foramen debridement combined with soft tissue soaking method was 90%. The score of ODI in group A was lower than that in group B on the 7th day after operation. Among the infection indexes, CRP and ESR in group A were much lower than those in group B at 3 and 7 days after the operation, and the difference was statistically significant （P < 0.05）. Conclusion Percutaneous transforaminal endoscopic debridement （PTED）in the treatment of lumbar spondylodiscitis combined with soft tissue immersion has a high bacterial culture rate, which can effectively reduce the pain of patients, improve the quality of life, and significantly reduce the index of infection. it is safe and effective for high-risk patients with multiple underlying diseases, strong bacterial virulence, high fever, high inflammation index, high risk of infection with internal fixation and inability to tolerate general anesthesia surgery.
- Bacterial infection,
- Lumbar spondylodiscitis,
- Percutaneous transforaminal endoscope,
- Minimally invasive treatment

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References(32)

References

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