Percutaneous endoscopic debridement and drainage in immunocompromised patients with complicated infectious spondylitis
Percutaneous endoscopic debridement and drainage in immunocompromised patients with complicated infectious spondylitis
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DOI：
10.3109/13645700903384450
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发表时间：
2010-02-01
影响因子：
1.7
通讯作者：
Chen, Wen-Jer
中科院分区：
文献类型：
--
作者：
Fu, Tsai-Sheng;Yang, Shih-Chieh;Chen, Wen-Jer
经皮内镜下清创引流术（PEDD）是治疗早期感染性脊柱炎的有效方法。然而，PEDD是否能有效治疗伴有明显脓肿形成或椎体破坏的复杂感染性脊柱炎尚不清楚。2名女性和4名男性一般健康状况不佳，并发化脓性脊柱炎，他们接受了PEDD。6例病原菌中有5例经PEDD鉴定。6例患者均表现为脊柱疼痛。5例患者报告在手术一周内背部疼痛缓解，并在全程特异性抗菌治疗后平稳恢复。这些患者的c反应蛋白（CRP）值在2 ~ 22周内恢复到正常范围。后续的核磁共振检查显示椎管旁脓肿或硬膜外脓肿已消失。在PEDD手术期间或之后没有发现手术相关的并发症。结论：PEDD治疗并发感染性脊柱炎疗效显著。我们认为，对于复杂的感染性脊柱炎，特别是有多种合并症的患者，PEDD是一种有效的替代手术的方法。
Percutaneous endoscopic debridement and drainage (PEDD) has been reported to be an effective procedure in treating early infectious spondylodiscitis. However, it is not clear whether PEDD can be effective in treating cases of complicated infectious spondylitis with significant abscess formation or vertebral destruction. Two women and four men with poor general health and complicated pyogenic spondylitis who underwent PEDD were evaluated. The causative bacteria were identified by PEDD in five of six. All six patients presented with spinal pain. Five patients reported relief from back pain within one week of surgery and recovered uneventfully after full course, specific, antimicrobial therapy. C-reactive protein (CRP) values returned to normal ranges within two to 22 weeks in these patients. The follow-up magnetic resonance imaging studies revealed that the paraspinal abscesses or epidural abscesses were resolved. No surgery-related complications were noted during or after the PEDD procedure. In conclusion, PEDD was effective in treating complicated infectious spondylitis. We propose that PEDD is an effective alternative to extensive surgery for complicated infectious spondylitis, especially in patients with multiple comorbidities.