Anterior Debridement For The Treatment Of Pyogenic Infection Of Cervical Intervertebral Space

Background: Pyogenic infection of cervical intervertebral space is an infection of the cervical intervertebral disc and adjacent cartilage endplate and vertebral body.The onset of the disease is insidious,the incidence is low,and the disease is easy to misdiagnose.The main manifestations were neck pain,elevated body temperature,intervertebral space collapse,instability of cervical spine,inverted arch deformity and the appearance of paravertebral and spinal abscess.The spinal cord or nerve root can be compressed to produce nerve root type pain and the movement sensation below the pressure plane.Long term and standardized application of antibiotics is the main treatment for cervical intervertebral space infection.But Surgery is needed for conservative treatment failure,combined spinal abscess,severe bone destruction,severe nerve compression in patients.The main purpose of surgical treatment is to completely clear the infection focus(lesion intervertebral disc,destruction of bone,abscess,etc.).Cervical anterior debridement,fusion and titanium plate internal fixation for the treatment of cervical intervertebral space infection can quickly remove the infected tissue,reduce neck pain,improve the cure rate of cervical spine to reconstruct thenormal sequence of cervical spine,to maintain the stability of cervical vertebrae,improve intervertebral fusion rate,reduce complications,reduce the risk of recurrent infection.Objective: To investigate the clinical results one-stage debridement,interbody fusion and instrument via the anterior approach for the treatment of pyogenic infection of cervical intervertebral spaceMethods: A retrospective of 13 cases(male 11 cases,female 2 cases)of cervical intervertebral infected patients from October 2010 to December 2014 who were treated by one-stage debridement,interbody fusion with cage and instrument via the anterior approach were analyzed,whose mean age was 53 years(range 45-62 years).All patients underwent anti-inflammatory treatment before and after surgery.All cases suffered from severe neck and shoulder pain.The scores before operation of Visual Analogue Scale(VAS)for pain were 5-10(everage,7.5±1.4)points.Nine cases had nerve function deficit,and the Japanese Orthopaedic Association(JOA)scores for cervical vertebrae were9-14(everage,11.0±2.2)point.Results: All cases followed up lasted for 12-24 months with an average of 15 months.The scores 3 months after operation of VAS for pain were1-3(everage,1.6±0.7)points and JOA cervical vertebra function score were14-17(everage,16.3±0.7)points.Comparing with preoperation,the excellent and good rate of TOA was 88.9%.Good fusion was present and no failure of internal fixation occurred in all cases.There was no recurrence and no severe complications were found in this group.Conclusion:One-stage debridement,interbody fusion with cage and instrument via the anterior approach can achieve good curative results in cervical intervertebral infection.when supplementing with antibiotic therapy.