Percutaneous endoscopic discectomy and drainage for infectious spondylitis.
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.
Yang
Shih-Chieh
SC
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fu-Shin Street, Kweishan, 333 Taoyuan, Taiwan.
Fu
Tsai-Sheng
TS
Chen
Lih-Huei
LH
Niu
Chi-Chien
CC
Lai
Po-Liang
PL
Chen
Wen-Jer
WJ
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*
D000900:Anti-Bacterial Agents