医学
外科
骨不连
放射性武器
脊椎骨膜炎
颈椎前路椎间盘切除融合术
回顾性队列研究
射线照相术
颈椎
作者
Sung Kyu Kim,Jong-Beom Park,Jaeyoon Chung,Dong‐Ho Lee,Young‐Yul Kim,Yong‐Jin Park,Nam-Hun Lee
出处
期刊:Spine
[Ovid Technologies (Wolters Kluwer)]
日期:2020-04-01
卷期号:45 (7): 431-437
被引量:9
标识
DOI:10.1097/brs.0000000000003298
摘要
In Brief Study Design. Retrospective multicenter case series. Objective. We sought to evaluate the safety and efficacy of anterior cervical plating in anterior cervical debridement and fusion (ACDF) for patients with cervical pyogenic spondylodiscitis (CPS). Summary of Background Data. Due to concerns about bacterial seeding on the foreign material after instrumentations in pyogenic infections, the safety and efficacy of anterior cervical plating for CPS are still undetermined and controversial. Little information is available about the safety and efficacy of anterior cervical plating to manage CPS. Methods. Twenty-three patients who underwent ACDF with (n = 12) or without (n = 11) plating for CPS were included. The mean age was 62.6 years. Medical records were reviewed and radiological parameters including segmental height, segmental angle, C2–C7 angle, and fusion status were analyzed. The mean follow-up period after surgery was 21.3 months. Results. After ACDF with plating, segmental height, segmental angle, and C2–C7 angle were significantly improved compared with preoperative conditions and remained well-maintained at the last follow-up. After ACDF without plating, three radiological parameters were also initially improved compared with preoperative condition, but significantly deteriorated to preoperative levels at the time of the last follow-up. The fusion rate was higher in the ACDF with plating group compared with the ACDF without plating group (90.9% vs. 63.6%; P < 0.01). One patient who received ACDF with plating and four patients who received ACDF without plating underwent revision surgery due to nonunion or bone graft dislodgement. No recurrence of pyogenic spondylodiscitis occurred in either group. Conclusion. ACDF with plating showed better surgical outcomes compared with ACDF without plating for CPS. We recommend the use of anterior cervical plating, which can provide biomechanical stability, for better healing of CPS. To our knowledge, this is the largest surgical case series of CPS. Level of Evidence: 4 Instrumentations in pyogenic infections have been blamed for disturbing antimicrobial penetration and infection eradication. In our study, anterior cervical debridement and fusion (ACDF) with plating showed better surgical outcomes compared with ACDF without plating for cervical pyogenic spondylodiscitis (CPS). We recommend the use of anterior cervical plating, which can provide biomechanical stability, for better healing of CPS.
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