title: Percutaneous endoscopic discectomy and drainage for infectious spondylitis.
abstract: Fifteen patients with infectious spondylitis were treated by percutaneous endoscopic discectomy and drainage (PEDD) and associated appropriate parenteral antibiotics. Infectious spondylitis was diagnosed clinically, on the basis of elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values, and on roentgenographic and magnetic resonance imaging (MRI) findings. Causative bacteria were identified in 13 (86.7%) of 15 biopsy specimens. Systemic antibiotics were administered according to sensitivity analyses of pathogens. All patients reported immediate back pain relief except for two, who required anterior debridement and fusion one week and two weeks later, respectively. Two other patients with recurrent infection and intractable pain underwent surgical intervention at one month and eight months after PEDD, respectively. The remaining 11 patients recovered uneventfully after full-course, specific, antimicrobial therapy. No surgery related complications or side effects were observed during at least 12 months of follow-up. In conclusion, PEDD can provide retrieval of sufficient specimens and has high diagnostic efficacy, thereby enabling prompt and appropriate antibiotic therapy to the offending pathogens. It can be considered an effective alternative for treating uncomplicated spondylitis.
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fu-Shin Street, Kweishan, 333 Taoyuan, Taiwan.
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Yang
authors.forename: Tsai-Sheng
authors.initials: TS
authors.lastname: Fu
authors.forename: Lih-Huei
authors.initials: LH
authors.lastname: Chen
authors.forename: Chi-Chien
authors.initials: CC
authors.lastname: Niu
authors.forename: Po-Liang
authors.initials: PL
authors.lastname: Lai
authors.forename: Wen-Jer
authors.initials: WJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology / Q000601:surgery; D003646:Debridement / Q000379:methods; D017587:Diskectomy, Percutaneous; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000382:microbiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000601:surgery; D012189:Retrospective Studies; D013166:Spondylitis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents