Minimizing the surgical approach in patients with spondylitis.
Minimizing the surgical approach in treating patients with spinal infections by using local antibiotic treatment and avoiding a ventral approach reduces the anesthesia and surgical risks in patients with comorbidities. In this study we used calcium sulphate pellets (OsteoSet T and the OsteoSet Bone-void Filler kit) as a delivery system for different antibiotics. Of a group of 32 patients with histologically and microbiologically diagnosed spondylitis, a cohort of 16 patients was treated by just a dorsal surgical approach in combination with a local antibiotic delivery system. Of these 16 patients, 14 patients showed a normalization of the infection parameters, no more bone loss in the spondylitic region, and a bony fusion after 6 to 9 months postoperatively. Two patients died from septic circumstances 4 and 6 weeks postoperatively. Two patients had to have one revision surgery because of a seroma; no other complications caused by the calcium sulphate pellets were observed. The use of calcium sulphate pellets as antibiotic delivery system allows a controlled local antibiotic therapy with an osteoconductive material in combination with a minimized surgical approach. Furthermore, calcium sulphate pellets have proven their reliable capability as bone void filler.
von Stechow
Dietrich
D
Department of Orthopaedic Surgery, University Hospital Frankfurt/Main, Frankfurt am Main, Germany. d.vonstechow@friedrichsheim.de
Scale
Detlev
D
Rauschmann
Michael Andre
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D018786:Bone Substitutes / Q000008:administration & dosage; D002133:Calcium Sulfate / Q000008:administration & dosage; D003131:Combined Modality Therapy; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013166:Spondylitis / Q000188:drug therapy* / Q000601:surgery*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D018786:Bone Substitutes; D002133:Calcium Sulfate