Successful treatment of spondylodiscitis using titanium cages - A 3-year follow-up of 22 consecutive patients
Successful treatment of spondylodiscitis using titanium cages - A 3-year follow-up of 22 consecutive patients
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DOI：
10.1080/17453670810016687
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发表时间：
2008-01-01
影响因子：
3.7
通讯作者：
Heyde, Christoph E.
中科院分区：
文献类型：
--
作者：
Robinson, Yohan;Tschoeke, Sven Kevin;Heyde, Christoph E.
背景和目的在脊柱感染引起的巨大骨缺损中使用金属植入物来支撑前柱是有争议的，迄今为止发表的结果相对较少。尽管金属植入物上存在细菌粘附，但高度血管化的脊柱由于丰富的肌肉覆盖而具有强大的免疫力是独一无二的。这可能允许使用金属植入物，其具有高稳定性和减少矫正损失的优点。这是一项回顾性研究的患者与spondylotis治疗与metal implants.Patients和方法，我们回顾性分析了结果在22个连续的患者（平均年龄69（43-82）岁，15名男子）与spondylotis（20腰椎和12胸椎间盘）谁收到了前钛笼植入。在13例病例中，可以确定病原体。结果术后随访32-47个月，平均36个月。炎症的愈合通过临床、放射学和实验室参数得到证实。平均VAS从术前的9.1（6-10）提高到最终随访时的2.6（0-6），最终随访时的平均奥斯韦斯特里残疾指数为17（0-76）。首选的方法是彻底清创，矫正畸形，并通过植骨进行额外的骨融合。稳定性增加，便于患者活动，使用前后植入物的矫正损失相对较小，这在治疗患有多种合并症的患者中具有相当大的优势。
Background and purpose The use of metal implants in large defects caused by spinal infection to support the anterior column is controversial, and relatively few results have been published to date. Despite the fact that there is bacterial adhesion to metal implants, the strong immunity of the highly vascularized spine because of rich muscle covering is unique. This possibly allows the use of metal implants, which have the advantage of high stability and reduced loss of correction. This is a retrospective study of patients with spondylodiscitis treated with metal implants.Patients and methods We retrospectively analyzed the outcome in 22 consecutive patients (mean age 69 (43-82) years, 15 men) with spondylodiscitis (20 lumbar and 12 thoracic discs) who had received an anterior titanium cage implantation. In 13 cases, the pathogen could be identified. Antibiotic treatment was continued for at least 12 weeks postoperatively.Results The mean follow-up was 36 (32-47) months. Healing of inflammation was confirmed by clinical, radiographic, and laboratory parameters. The mean VAS improved from 9.1 (6-10) preoperatively to 2.6 (0-6) at the final follow-up, and the mean Oswestry disability index was 17 (0-76) at the final follow-up.Interpretation Our findings highlight the high healing rate and stability when titanium implants are used. Prerequisites are a radical debridement, correction of deformity, and additional bony fusion by bone grafting. The increased stability, with facilitated patient mobilization, and the relatively little loss of correction using anterior and posterior implants are of considerable advantage in the treatment of the patients with multiple co-morbidities.