Percutaneous transpedicular management of discitis
Percutaneous transpedicular management of discitis
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DOI：
10.1016/s1051-0443(96)70871-0
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发表时间：
1996-11-01
影响因子：
2.9
通讯作者：
Walser, E
中科院分区：
文献类型：
--
作者：
Arya, S;Crow, WN;Walser, E
目得：介绍经皮经椎弓根穿刺活检和椎间盘清创术在诊断和治疗arthritis.MATERIALS和METHODS的技术：15例患者进行了椎间盘穿刺活检，通过经椎弓根的方法与局部麻醉和荧光镜引导。尝试尽可能清除椎间盘。当持续引流时，通过经椎弓根道部署外科真空引流管。结果：15例患者接受经皮经椎弓根椎间盘活检和椎间盘清创术，以治疗疑似椎间盘炎。3例患者仅接受活检，12例患者接受经皮椎间盘切除术。6例患者至少有1次培养阳性。8例接受椎间盘切除术的患者疼痛或神经症状立即改善，避免了椎间盘的紧急手术清创。四名患者没有改善，并进行了手术清创和fusion.CONCLUSIONS：经椎弓根活检的光盘是一种有效的技术，充分的组织检索和诊断的腰椎管炎。在选定的患者中进行充分的清创和抗生素治疗可能是决定性的。硬膜外扩张的腰椎炎和大量的椎体破坏排除了经皮治疗。
PURPOSE: To present the technique of percutaneous transpedicular biopsy and debridement of discs in diagnosis and management of discitis.MATERIALS AND METHODS: Fifteen patients underwent disc biopsy through a transpedicular approach with local anesthesia and fluoroscopic guidance. An attempt was made to debride the disc as much as possible. A surgical vacuum drain was deployed through the transpedicular tract when there was persistent drainage.RESULTS: Fifteen patients underwent percutaneous transpedicular disc biopsy and debridement of disc for suspected discitis. Three patients underwent biopsy only and 12 underwent percutaneous discectomy. Six patients had at least one positive culture. Eight patients who underwent discectomy had immediate improvement of pain or neurologic symptoms, obviating emergency surgical debridement of the disc. Four patients did not improve and underwent surgical debridement and fusion.CONCLUSIONS: Transpedicular biopsy of the disc is an effective technique for adequate tissue retrieval and diagnosis of discitis. Adequate debridement in selected patients with antibiotic therapy may be definitive. Epidural extension of discitisand massive vertebral destruction precludes percutaneous treatment.