Percutaneous internal fixation in the management of lumbar spondylitis: report of two cases.
Surgically managed bacterial spondylitis is rare, and a variety of operative techniques are currently available, without any real consensus. The present study reports an original, less invasive surgical treatment for spondylitis, in two patients. An initial percutaneous posterior instrumentation fixation was followed by an anterior interbody graft performed through a retroperitoneal route. Postoperative bacterial typing was done; pain resolution was obtained in both patients. Control CT scan showed good restitution of the disk space height and a satisfactory reduction of the local kyphosis. Fusion was achieved at 6 months in both cases, with stable results at long-term follow-up. In patients presenting comorbid conditions, this technique gave interesting preliminary results, was less traumatic and shorter to perform, and finally entailed a limited operative risk.
Neurosurgery Department, La Timone Teaching Medical Center, 249, rue Saint-Pierre, 13005 Marseille, France.
B
B
Blondel
S
S
Fuentes
P
P
Metellus
T
T
Adetchessi
H
H
Dufour
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods*; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010147:Pain Measurement; D018570:Risk Assessment; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000379:methods*; D013166:Spondylitis / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents