| Background: The incidence of lumbar spine infections is on the rise because of aging of the population,iatrogenic invasive operations,and the abuse of drugs,intravenous drugs,and immunosuppressants.Treatment is mainly conservative.surgical treatment is considered when conservative treatment effect is poor or infection leads to spinal instability or nerve compression.The surgical of posterior approach has some disadvantages,such as difficulty in completely removing the lesions in the anterior column and lead into large damage.In recent years,the Oblique Lateral Interbody Fusion Corridor(OLIF)has emerged and became popular at home and abroad.This approach has unique advantages for lumbar surgery and widely used in lumber degeneration treatment,but the treatment of lumbar intervertebral space infection under this approach is at the beginning stage,and the efficacy and safety still need to be confirmed by clinic.Objective: Clinical efficacy analysis of single-level lumbar pyogenic spondylodiscitis treated in one-stage with OLIF corridor debridement,bone autograft combined with mini-invasive pedicle screw system guided by navigation Methods: This was a retrospective study: A total of 22 patients with single-level lumbar pyogenic spondylodiscitis treated in one-stage with OLIF corridor debridement,bone autograft combined with mini-invasive pedicle screw system guided by navigation were followed up in our hospital from January 2015 to September 2018 with an average follow-up time of 16.03±4.7 months,aged 38-71 years,and an average age of 53.9±9 years,including 16 males and 6 females.All the cases were single segment infection,among which 6 cases were in L2/3,6 cases in L3/4,and 10 cases in L4/5.The patients’ basic conditions,types of infected bacteria,operative time,intraoperative blood loss,and postoperative complications were recorded.The clinical efficacy was evaluated by visual analogue scale(VAS)and oswestry disability index(ODI).Observing whether the internal fixation is loose,fracture and fusion by observing the imaging examination(X-ray,CT).Results: The operation time was 121.09±31.28 min(range,103-141min),and blood loss was 115.90±73.26 ml,and hospitalization time was 11.68±3.35 days.Among the 22 cases,9 cases were positive in bacterial culture,5 cases of Staphylococcus aureus,2 cases of Escherichia coli and 2 cases of Streptococcus,and the rest were negative.Pathological examination of all patients indicated acute and chronic inflammatory manifestations.In all patients followed up,the symptoms gradually improved during the treatment.the VAS score decreased from 8.82±1.33 points before surgery to 0.9±0.5 points at the last follow-up and the score of ODI decreased from(66.5±7.9)% to(8.7±5.9)%.The intervertebral space height and the lordosis angle of intervertebral space were recovered satisfactorily after the operation,and the intervertebral space height and the lordosis angle of intervertebral space were lost to some extent during the follow-up.Three patients developed gastrointestinal reactions(flatulence),one patient developed pleural effusion,and four patients discomfort in the medial anterior thigh.Postoperative complications have been alleviated within 1 month by symptomatic treatment.Conclusion: The clinical effect of single-level lumbar pyogenic spondylodiscitis treated in one-stage with OLIF corridor debridement,bone autograft combined with mini-invasive pedicle screw system guided by navigation is satisfactory.This study shows that this operation method is effective in lesion removal,less trauma,high fusion rate,and conducive to the recovery of intervertebral space,providing a new option for minimally invasive treatment. |
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