36 0

A New Surgical Strategy for Infective Spondylodiscitis: Comparison Between the Combined Antero-Posterior and Posterior-Only Approaches

Title
A New Surgical Strategy for Infective Spondylodiscitis: Comparison Between the Combined Antero-Posterior and Posterior-Only Approaches
Author
강창남
Keywords
corpectomy; infection; initial height loss; kyphosis; posterior instrumentation; spondylodiscitis; surgical approach; wedge angle
Issue Date
2020-10
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
SPINE, v. 45, no. 19, page. E1239-E1248
Abstract
Study Design. Retrospective comparative study. Objective. To investigate the radiographic and clinical effectiveness of surgical treatment using a posterior-only approach, as compared with a combined antero-posterior approach, in patients with infective spondylodiscitis. Summary of Background Data. Spondylodiscitis is the most common infectious disease of the spine. There is currently no consensus over the surgical approach, use of bone graft, and type of instrumentation for optimal treatment of infective spondylodiscitis. Methods. Seventy-nine patients who received surgical treatment for infective spondylodiscitis were divided into a combined antero-posterior (AP) group and a posterior-only (P) group. Significant differences in pre- and postoperative radiographic and clinical characteristics between the two groups were identified, and univariate and stepwise multivariate logistic regression analyses were used to determine the factors that affected the decision for treatment approach between the two groups. Results. Preoperatively, initial height loss, wedge angle, and kyphotic angle were significantly higher in the AP group. However, estimated blood loss, operation time, and last visual analogue scale score for back pain were significantly lower in the P group. There was no difference in postoperative time to reach solid fusion. Postoperative corrected kyphotic angle was 12.8° in the AP group and 5.3° in the P group. The regional wedge angle was identified as a factor that influenced use of the combined antero-posterior approach, with a sensitivity of 60%, and specificity of 89.8% at the optimal cut-off value of 8.2°. Conclusion. Interbody fusion with long-level pedicle screws fixation through a posterior-only approach was shown to be as effective as a combined antero-posterior approach for the surgical treatment of infective spondylodiscitis. A posterior-only approach is recommended when the regional wedge angle of the collapsed vertebra is less than 8.2°. Level of Evidence: 4
URI
https://journals.lww.com/spinejournal/Fulltext/2020/10010/A_New_Surgical_Strategy_for_Infective.8.aspxhttps://repository.hanyang.ac.kr/handle/20.500.11754/172014
ISSN
0362-2436; 1528-1159
DOI
10.1097/BRS.0000000000003544
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE