Unilateral Posterolateral Approach for Disc Debridement and Titanium Cage Insertion Supplemented by Contralateral Transfascial Screw Fixation for Sick Patients Suffering From Septic Thoracolumbosacral Spondylodiscitis
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Discitis
- Sponsor
- University Hospital of Patras
- Enrollment
- 20
- Primary Endpoint
- The extent of spinal cord injury (SCI) defined by the American Spinal Injury Association (ASIA) Impairment Scale
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
This retrospective study assess the efficacy and safety of a posterolateral unilateral approach for debridement and titanium cage insertion supplemented by contralateral transfascial screw fixation for sick patients suffering from septic thoracolumbosacral spondylodiskitis. Hematogenous pyogenic spondylodiskitis requires surgical intervention in cases of development of neurological signs, spinal instability, progressive spinal deformity and abscess. When operative treatment is indicated, an anterior approach by open thoracotomy or by a thoraco-abdominal approach or combined anterior and posterior approaches are recommended. In cases of severe sick patients anterior approach is associated with high morbidity and mortality.
Detailed Description
Twenty consecutive sick (ASA\>III) patients, 14 men and 6 women, aged 64±14 years, suffering from single level septic thoracolumbosacral spondylodiskitis underwent an one-stage less invasively unilateral posterolateral decompression, insertion of titanium cage\& pedicle screw fixation plus contralateral transfascial pedicle screw fixation.
Investigators
Vasileios Syrimpeis
Orthopaedic Surgeon
University Hospital of Patras
Eligibility Criteria
Inclusion Criteria
- •Single-level thoracic, thoracolumbar, lumbar or lumbosacral spondylodiskitis
- •Medical comorbidities were present in all 20 patients. These included diabetes mellitus, chronic renal insufficiency, advanced heart insufficiency, hypertension, cortisone abuse, drug abuse and/or advanced age (\>65y).
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
The extent of spinal cord injury (SCI) defined by the American Spinal Injury Association (ASIA) Impairment Scale
Time Frame: 2 years
Grade A Complete lack of motor and sensory function below the level of injury (including the anal area) Grade B Some sensation below the level of the injury (including anal sensation) Grade C Some muscle movement is spared below the level of injury, but 50 percent of the muscles below the level of injury cannot move against gravity. Grade D Most (more than 50 percent) of the muscles that are spared below the level of injury are strong enough to move against gravity. Grade E All neurologic function has returned.
Secondary Outcomes
- Survival rate at 2,5 years(2,5 years)
- Survival rate at 10 years(10 years)