title: Clinical outcomes of percutaneous curettage and continuous irrigation for pyogenic spondylitis.
abstract: BACKGROUND
  Several recent studies have reported percutaneous curettage and continuous irrigation as effective treatments for pyogenic spondylitis. However, factors affecting the normalization of CRP levels remain unclear. This retrospective study investigated the clinical outcomes of percutaneous curettage and continuous irrigation for pyogenic spondylitis, and factors affecting the duration until normalization of CRP levels.
  
  
  METHODS
  Subjects comprised 16 patients who underwent percutaneous curettage and continuous irrigation for pyogenic spondylitis. Patients were divided into 3 groups according to duration from surgery until normalization of CRP levels to <or=0.20 mg/dL: early (n = 5), <or=2 weeks; middle (n = 6), <or=6 weeks; and delayed (n = 5), >6 weeks. Clinical and radiographic findings were compared between groups.
  
  
  RESULTS
  Japanese Orthopaedic Association score was improved in all patients within 2 weeks after surgery. Preoperative CRP level was lower in the early group (0.55 +/- 0.27 mg/dL) compared with the middle (2.63 +/- 1.84 mg/dL; P < .05) and delayed groups (7.59 +/- 10.44; P < .05). Duration of irrigation was shorter in the delayed group (10.7 +/- 3.7 days) compared with the early (15.6 +/- 2.0 days; P < .05) and middle groups (15.5 +/- 3.0 days; P < .05). Findings on MRI improved within 2 months in the early and middle groups.
  
  
  CONCLUSIONS
  This treatment is minimally invasive and useful in patients with pyogenic spondylitis. Lower CRP level before surgery and longer duration of irrigation may reduce the duration to normalization of CRP level.
authors.affiliation: Department of Orthopaedic Surgery, Kagawa University Faculty of Medicine, Miki-cho, Kagawa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Komatsubara
authors.forename: Sei
authors.initials: S
authors.lastname: Shibuya
authors.forename: Nobuo
authors.initials: N
authors.lastname: Arima
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D002097:C-Reactive Protein / Q000032:analysis; D003475:Curettage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D013131:Spine / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D013166:Spondylitis / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D007507:Therapeutic Irrigation / Q000295:instrumentation / Q000379:methods*; D013995:Time; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein