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Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine.

Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views.

Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one.

Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.

권호기사

권호기사 목록 테이블로 기사명, 저자명, 페이지, 원문, 기사목차 순으로 되어있습니다.
기사명 저자명 페이지 원문 목차
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Inferolateral Entry Point for C2 Pedicle Screw Fixation in High Cervical Lesions Kwangho Lee, Dong-Ho Kang, Chul Hee Lee, Soo Hyun Hwang, In Sung Park, Jin Myung Jung pp.341-347

The Comparison of Outcome between Thromboaspiration and Aggressive Mechanical Clot Disruption in Treating Hyperacute Stroke Patients Hyun Goo Lee, Yoon Hee Kim, Seung Hun Sheen, Jong Kook Rhim, Sung Han Oh, Bong Sub Chung pp.311-316

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Polymorphisms of Integrin, Alpha 6 Contribute to the Development and Neurologic Symptoms of Intracerebral Hemorrhage in Korean Population Hyun-Kyung Park, Dae Jean Jo pp.293-298

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참고문헌 (43건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 In vitro and in vivo comparative colonization of Staphylococcus aureus and Staphylococcus epidermidis on orthopaedic implant materials 네이버 미소장
2 Overview and classification of spinal infections. 네이버 미소장
3 Carragee EJ : Instrumentation of the infected and unstable spine : a review of 17 cases from the thoracic and lumbar spine with pyogenic infections. J Spinal Disord 10 : 317-324, 1997 미소장
4 Pyogenic vertebral osteomyelitis. 네이버 미소장
5 Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting. 네이버 미소장
6 Preliminary results of staged anterior debridement and reconstruction using titanium mesh cages in the treatment of thoracolumbar vertebral osteomyelitis 네이버 미소장
7 Percutaneous endoscopic debridement and drainage in immunocompromised patients with complicated infectious spondylitis. 네이버 미소장
8 Two-Stage (Posterior and Anterior) Surgical Treatment Using Posterior Spinal Instrumentation for Pyogenic and Tuberculotic Spondylitis 네이버 미소장
9 Experience with the suction-irrigation technique in the management of spinal epidural infection. 네이버 미소장
10 Percutaneous discectomy for the treatment of bacterial discitis. 네이버 미소장
11 Hematogenous pyogenic spinal infections and their surgical management. 네이버 미소장
12 Percutaneous drainage and continuous irrigation in patients with severe pyogenic spondylitis, abscess formation, and marked bone destruction 네이버 미소장
13 Magnetic resonance imaging and the nonoperative treatment of spinal epidural abscess 네이버 미소장
14 Spinal epidural abscess 네이버 미소장
15 Clinical outcome of posterolateral endoscopic surgery for pyogenic spondylodiscitis: results of 15 patients with serious comorbid conditions. 네이버 미소장
16 Bacteremic Staphylococcus aureus spondylitis. 네이버 미소장
17 Increasing frequency of vertebral osteomyelitis following Staphylococcus aureus bacteraemia in Denmark 1980–1990 네이버 미소장
18 Karadimas EJ, Bunger C, Lindblad BE, Hansen ES, Høy K, Helmig P, et al. : Spondylodiscitis. A retrospective study of 163 patients. Acta Orthop 79 : 650-659, 2008 미소장
19 Clinical outcomes of percutaneous curettage and continuous irrigation for pyogenic spondylitis 네이버 미소장
20 Anterior Surgery With Insertion of Titanium Mesh Cage and Posterior Instrumented Fusion Performed Sequentially on the Same Day Under One Anesthesia for Septic Spondylitis of Thoracolumbar Spine 네이버 미소장
21 Diagnosis and results of different treatment regimens in patients with spinal abscesses. 네이버 미소장
22 Legrand E, Flipo RM, Guggenbuhl P, Masson C, Maillefert JF, Soubrier M, et al. : Management of nontuberculous infectious discitis. treatments used in 110 patients admitted to 12 teaching hospitals in France. Joint Bone Spine 68 : 504-509, 2001 미소장
23 Pyogenic spinal sepsis in adults. 네이버 미소장
24 Martin RJ, Yuan HA : Neurosurgical care of spinal epidural, subdural, and intramedullary abscesses and arachnoiditis. Orthop Clin North Am 27 : 125-136, 1996 미소장
25 Spontaneous infectious spondylodiscitis in an internal medicine department: epidemiological and clinical study of 41 cases 네이버 미소장
26 McGee-Collett M, Johnston IH : Spinal epidural abscess : presentation and treatment. A report of 21 cases. Med J Aust 155 : 14-17, 1991 미소장
27 Percutaneous suction aspiration and drainage for pyogenic spondylitis. 네이버 미소장
28 Nussbaum ES, Rigamonti D, Standiford H, Numaguchi Y, Wolf AL, Robinson WL : Spinal epidural abscess : a report of 40 cases and review. Surg Neurol 38 : 225-231, 1992 미소장
29 Pee YH, Park JD, Choi YG, Lee SH : Anterior debridement and fusion followed by posterior pedicle screw fixation in pyogenic spondylodiscitis : autologous iliac bone strut versus cage. J Neurosurg Spine 8 : 405-412, 2008 미소장
30 Epidural abscess complicating insertion of epidural catheters 네이버 미소장
31 Picada R, Winter RB, Lonstein JE, Denis F, Pinto MR, Smith MD, et al. : Postoperative deep wound infection in adults after posterior lumbosacral spine fusion with instrumentation : incidence and management. J Spinal Disord 13 : 42-45, 2000 미소장
32 Neurosurgery 네이버 미소장
33 Safety of instrumentation in patients with spinal infection. 네이버 미소장
34 Surgical treatment of the spontaneous spinal epidural abscess 네이버 미소장
35 Reihsaus E, Waldbaur H, Seeling W : Spinal epidural abscess : a meta-analysis of 915 patients. Neurosurg Rev 23 : 175-204; discussion 205, 2000 미소장
36 Evaluation: Business or Vocation? 네이버 미소장
37 Instillation-suction technique in chronic osteomyelitis. 네이버 미소장
38 Continuous Irrigation in Pyogenic Spondylitis Accompanied by Iliopsoas Abscess 네이버 미소장
39 Magnetic Resonance Imaging of Cerebrospinal Fluid Leak and Tamponade Effect of Blood Patch in Postdural Puncture Headache 네이버 미소장
40 The use of closed-suction irrigation systems to manage spinal infections. 네이버 미소장
41 Wisneski RJ : Infectious disease of the spine. Diagnostic and treatment considerations. Orthop Clin North Am 22 : 491-501, 1991 미소장
42 Yoon SH, Chung SK, Kim KJ, Kim HJ, Jin YJ, Kim HB : Pyogenic vertebral osteomyelitis : identification of microorganism and laboratory markers used to predict clinical outcome. Eur Spine J 19 : 575-582, 2010 미소장
43 Percutaneous Suction Aspiration for I Osteomyelitis 네이버 미소장