[Percutaneous CT-controlled puncture and drainage of spondylodiscitis--a minimally invasive method].
OBJECTIVE
Is there an absolute operative indication for the abscess-forming spondylodiscitis or is a curing also possible with minimal invasive procedures?


METHODS
In a retrospective study over a period from 1986 to 1993, 40 patients with a spondylodiscitis of the thoracic and lumbar spine were treated and then followed up over two years in our Department of Orthopedic Surgery. Using a CT-controlled method of minimal invasive punction and drainage of the abscessed forms of spondylodiscitis, it was to be settled whether these therapeutic procedures result in a normalization of the biochemical inflammatory parameters (CRP) and in a normalization of the CT--as well as MRI-findings.


RESULTS
7 of the 40 patients had a spondylodiscitis with a local abscess, further 7 patients had a gravidation abscess. 92.5% of the cases were treated conservatively and minimal invasively, respectively. In 11 patients the minimal invasive procedure was used in addition to conservative therapy. 3 cases had to be operated on. A recurrence of the spondylodiscitis was seen in 1 patient; complications (n = 2; 1 x pneumonia, 1 x venous thrombosis) occurred in 5% of all patients.


CONCLUSIONS
Minimal invasive therapy with CT-controlled punction or drainage may be a good alternative to the operative intervention in the predominantly old and multimorbid patients with abscessed forms of spondylodiscitis. The risk is minimized, the immobilizing period was 8.7 weeks on average.
Weber
M
M
Orthopädische Universitätsklinik der RWTH Aachen.
Heller
K D
KD
Wirtz
D
D
Zimmermann-Picht
S
S
Keulers
P
P
Zilkens
K W
KW
D000038:Abscess / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015299:Discitis / Q000000981:diagnostic imaging / Q000601:surgery*; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D011677:Punctures / Q000295:instrumentation*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*; D016896:Treatment Outcome