Clinical Study For The Treatment Of Cervical Intervertebral Infection Via One-stage Anterior Debridement And Bone Grafting And Internal Fixation

Objective: To explore the clinical effect of one-stage debridement and bone graft fusion in the treatment of cervical intervertebral space infection.Method: A retrospectively analysis the data of 68 cases?male 42 cases,female 26 cases?with cervical interverbral infected patients from june 2010 to june 2014 who were treated with an one-stage debridement and bone graft fusion and complete follow-up.The average age of those patients was 53.6 years?range,17-79 years?.56 cases were involved in single level(C_2/3 3 cases,C_3/4 9 cases,C_4/5 15 cases,C_5/6 24 cases,C6/7 3 cases),12 cases in the adjacent two level(C_2/3andC_3/4 3 cases,C_3/4andC_4/5 2 cases,C_4/5and C_5/6 7 cases).Accoring to the confirming diagnosis,patients underwent postperatively anti-inflammatory treatment.The infection controlling statues was evaluated base on laboratory result of erythrocyte sedimentation rate and C-reactive protein.The fusion score was evaluated by Eck fusion and grading criteria.The clinical effects was evaluated from the Visual Analogue Scale and the Japanese Orthopedic Association?Cervical?.Result: 68 patients were successfully completed the operation,The average time of the operation was 70min?range,60-90min?.intraoperative blood loss 30-150 ml,an average of 88 ml.14 cases was diagnosed as pyogenic infection,39 cases was diagnosed as tuberculous infection,brucellosis Infection was found in 8 cases,7 cases was diagnosed as unknown infections.Mean follow-up duration was 15.7 months?range,13-32 months?.All of 68 cases of patients' symptom were significantly improved.The cervical VAS score: average 5.3 ± 2.7points before operation,average 2.3 ± 2.5 points one month after operation,average 0.9 ±1.6 points six months after operation,and an average score of 1.0 ± 1.3 points by the lastfollowup time.The postoperative VAS score was significantly lower than that before operation,The difference was statistically significant?P <0.05?.The JOA score: average10.8 ± 3.5 points before operation,average 13.4 ± 4.7 points one month after operation,average 15.6 ± 3.6 points six months after operation,and an average score of 15.9 ± 2.5points by the last followup time.JOA improvement rate was 78.4%.All patients with ERS and C-reactive protein were normal in the last follow-up time.All patients were not found in bone graft absorption,inter-segment collapse,pseudarthrosis formation,infection recurrence and internal fixation loosening and fracture in the follow-up period.7 patients had hoarseness after operation,follow-up observation after a month of recovery.Two patient with pyogenic infectious occured wound fluided after released 14 days later,and healed after a repeatedly surgery.Conclusion: an one-stage debridement and bone graft fusion in the treatment of cervical intervertebral space infection that can completely remove the lesion,remove the nerve compression and provide a strong internal fixation,the patients can obtain targeted anti-inflammatory treatment,the clinical efficacy satisfied.