Efficacy Analysis Of Retroperitoneal Laparoscopic Surgery For Lumbar Discitis

ObjectiveTo investigate the clinical efficacy and feasibility of laparoscopic retroperitone alapproach to treat single-level lumbar discitis with debridement and continuou-slyclosed irrigation.MethodsFrom May 2012 to February 2015,10 patients with single-level lumbar discitis were treated by retroperitoneoscopic debridement and continuously closed irrigation(without autogenous bone graft and instrumentation)with immobilization andantibiotic postoperatively.The operation time,intraoperative blood loss,isolation of the pathogen and operative complications were recorded.Erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were used as ambulatory monitoring parameters for infection control.To evaluate the surgical outcome and recovery,Visual analogue scale(VAS)for back pain and Oswestry disability index(ODI)were used.Imaging evaluation included plain X-ray,CT scan and MRI.ResultsThe operation time was 88.3(range,70?120)min;the intraoperative blood 1 oss was 97.0(range,40?190)ml;the results of pathogen culture included C andida pseudotropicalis in 1 case,Staphylococcus epidermidis in 2 cases,M-et hicillin-resistant Staphylococcus aureus(MRSA)in 1 case,infection mixed with Escherichia coli and Acinetobacter baumannii in 1 case,negative in 5 cases.The patients obtained satisfactory back pain relief afteroperation.C-reactive p rotein(CRP)almost dropped to normal when the patients were discharged.Th e mean follow-up time was 27.6(range,24?36)months.The function of lum bar spine resumed well in all cases and there was little influence on their dai 1y life and work.There was no statistically significant difference in VAS for back pain and ODI between the 1-and 2-year postoperatively(P>0.05).At t he final follow-up,imageology examination showed appearance of lost of inter vertebral space and circumferential bone bridging of all patients,evidence of i nterbody bony fusion developed in 7 patients.No infection relapse and operat ive complications happened during the follow-up.ConclusionsRetroperitoneal laparoscopic surgery is suitable for single-level lumbar discitis without evident spinal instability and vertebral body collapse with kyphosis.It can erase foci of infection rapidly and obtain good and reliable clinical outcome.