PYOGENIC VERTEBRAL OSTEOMYELITIS - TREATMENT BY ANTERIOR SPINAL DEBRIDEMENT AND FUSION

被引：80

作者：

FANG, D ^{[1
]}

CHEUNG, KMC ^{[1
]}

DOSREMEDIOS, IDM ^{[1
]}

LEE, YK ^{[1
]}

LEONG, JCY ^{[1
]}

机构：

[1] UNIV HONG KONG,QUEEN MARY HOSP,FAC MED,DEPT ORTHOPAED SURG,5F PROFESSORIAL BLOCK,POKFULAM RD,HONG KONG,HONG KONG

来源：

JOURNAL OF SPINAL DISORDERS | 1994年 / 7卷 / 02期

关键词：

VERTEBRAL OSTEOMYELITIS; PYOGENIC SPONDYLITIS; ANTERIOR SPINAL FUSION;

D O I：

10.1097/00002517-199407020-00012

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Forty-three patients with pathologically proven vertebral osteomyelitis were studied between 1957 and 1990. Thirty-nine underwent anterior debridement and fusion, and four underwent anterior debridement only. The indications for surgery were uncertain diagnosis, persistent pain, failed conservative treatment with uncontrolled sepsis, and neurological involvement. Thirty patients were followed-up for an average period of 5 years, with a minimum of 2 years and the longest for 15 years. All their symptoms improved after surgery; only one patient subsequently deteriorated due to multiple level recurrence. All patients with neurological deficit improved. Bony fusion occurred in 93% of cases (average time to fusion, 6.8 months), and 90% of the patients were able to return to their original work 4-20 months after surgery. We feel that anterior debridement and spinal fusion allow for reliable microbiological and histological diagnosis, and rapid relief of symptoms and return to work. Primary bone grafting is successful despite the presence of infection.

引用

页码：173 / 180

页数：8

共 16 条

[1]

Abramovitz J.N., Batson R.A., Yablom J.S., Vertebral osteomyeli¬tis. Surgical management of neurological complications, Spine, 11, pp. 418-420, (1986)

[2]

Cotty P., Fouquet B., Pleskof L., Vertebral osteomyelitis: Value of percutaneous biopsv. 30 cases, J Neitroradiol, 15, (1988)

[3]

Digby J.M., Kersley J.B., Pyogenic non-tuberculous spinal infec-tion, J Bone Joint Surg [Br] 61 B, pp. 47-55, (1979)

[4]

Emery S.E., Chan D.P., Woodward H.R., Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting, Spine, 14, (1989)

[5]

Frankel H.L., Hancock D.O., Hyslop G., The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Part I, Paraplegia, 7, pp. 179-192, (1969)

[6]

Garcia A.J., Grantham S.A., Hematogenous pyogenic vertebral osteomyelitis, J Bone Joint Surg [Am], 42, (1960)

[7]

Griffiths H., Jones D.M., Pyogenic infection of spine, J Bone Joint Surg [Br], 53, (1971)

[8]

Hale J.E., Aichroth P., Vertebral osteomyelitis: A complication of urological surgery, Br J Surg, 61, (1974)

[9]

Kemp H., Jackson J.W., Jeremiah J.D., Cook J., Anterior fusion of the spine for infective lesions in adults, J Bone Joint Surg [Br], 55, (1973)

[10]

Kulowski J., Pyogenic osteomvelitis of the spine, J Bone Joint Surg, 18, (1936)

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