title: Surgical results of percutaneous suction aspiration and drainage for pyogenic spondylitis.
abstract: Forty patients (24 male and 16 female; age 13-87 years, mean 66 years) with pyogenic spondylitis were treated by percutaneous suction aspiration and drainage between January 1997 and September 2007 at Kurume University Hospital. The surgical procedure and transpedicular approach were similar to those used for percutaneous discectomy in the treatment of intervertebral disc herniation. The average postoperative follow-up period was 22.6 months. Two patients had died by the time of the survey, and two had undergone multiple operations. The clinical outcomes were excellent in 12 patients, good in 17 patients, fair in 5 patients, and poor in 6 patients. The response rate (cases with "excellent" or "good" outcomes) was 72.5% (29 patients). Identification of the organism was possible in 26 patients (65%). The most frequently identified organism was methicillin-resistant Staphylococcus aureus (MRSA; 11 cases), followed by methicillin-sensitive Staphylococcus aureus (MSSA; 5 cases) and Escherichia coli (3 cases). Percutaneous suction aspiration and drainage has been demonstrated as an effective means of treating early spondylitis. This procedure is minimally invasive and enables pathogen identification, histopathological diagnosis and even simultaneous treatment. This is the only means of treatment available for patients who cannot tolerate open surgery. This therapy also promises medico-economic advantages by shortening treatment periods and eliminating open surgery.
authors.affiliation: Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume, Japan. n.ando0316.964@gmail.com
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Ando
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Sato
authors.forename: Mamoru
authors.initials: M
authors.lastname: Mitsukawa
authors.forename: Kei
authors.initials: K
authors.lastname: Yamada
authors.forename: Toru
authors.initials: T
authors.lastname: Wakioka
authors.forename: Kensei
authors.initials: K
authors.lastname: Nagata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017587:Diskectomy, Percutaneous; D004322:Drainage; D004927:Escherichia coli Infections / Q000601:surgery / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D013166:Spondylitis / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy*; D013203:Staphylococcal Infections / Q000601:surgery / Q000628:therapy; D013211:Staphylococcus aureus; D013396:Suction / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult