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2015 ; 94
(47
): e2110
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A Retrospective Study of 39 Patients Treated With Anterior Approach of Thoracic
and Lumbar Spondylodiscitis: Clinical Manifestations, Anterior Surgical
Treatment, and Outcome
#MMPMID26632729
Yaldz C
; Özdemir N
; Yaman O
; Feran HG
; Tansug T
; Minoglu M
Medicine (Baltimore)
2015[Nov]; 94
(47
): e2110
PMID26632729
show ga
The aim of this study is to report our 39 patients treated with anterior
debridement and autologous iliac bone grafting with or without anterior
instrumentation, which is the presumed treatment of choice for thoracic or lumbar
spondylodiscitis.Our patients underwent surgical treatment of spondylodiscitis
using anterior debridement and autologous iliac bone grafting with or without
anterior instrumentation and were analyzed with a mean follow-up of 8 years
(range, 2-11 years). Kaneda 2-rod system instrumentation was used in 12 patients,
in total. Clinical outcomes were assessed by the Frankel grade. Radiographic
fusion was characterized based on 3-dimensional computed tomography.Of the whole
group, 20 patients suffered from tuberculous spondylodiscitis and 19 suffered
from hematogenous spondylodiscitis. Pathogens responsible for pyogenic infection
included Staphylococcus aureus (4 patients), Pseudomonas aeruginosa (3 patients),
and Brucella melitensis (1 patient). Fifteen patients had thoracic involvement,
20 had lumbar involvement, and 4 had thoracolumbar junction involvement.
Preoperative neurological deficits were noted in 13 of the 39 patients. In terms
of Frankel grade, 8 patients have improved, 4 have remained the same, and 1
patient has worsened during the follow-up period. Imaging-documented fusion was
achieved in 23 of 27 patients in the graft group (85% fusion rate) and 11 of 12
patients in the graft + Kaneda instrumentation group (91% fusion rate).There was
no instrumentation failure, loosening, or graft-related complication such as
slippage or fracture of the graft. This approach demonstrated a good recovery
rate of neurological functions and a high fusion rate.