Abstract
Objective
To evaluate the outcomes of debridement fusion surgery between two surgical approaches for one- or two-level lumbar vertebral osteomyelitis (LVO): oblique retroperitoneal approach (ORA) and posterior transpedicular approach (PTA).
Methods
We performed a retrospective study for adult patients with one- or two-level lumbar vertebral pyogenic spondylitis. The primary clinical outcomes included the following: surgery-related information (intra-operative blood loss, operation time, and hospital length of stay), infection control (primary failure and recurrence), and bony fusion. The secondary objective was to determine the differences between groups in mean reduction of pain characters and physical functioning.
Results
The data of 80 patients were collected retrospectively. The duration of follow-up was 27.8 ± 4.7 months (range, 24–42). Intra-operative blood loss, operation time, and hospital length of stay in ORA debridement were significantly lower. Primary failure (2.3% vs 2.7%) was similar between the groups, but recurrence (13.9% vs 5.4%) had difference. Bony fusion (94.6.3% vs 86.1.%) in ORA debridement was higher than those in PTA debridement at the final follow-up. Fusion occurred at six to 14 months (mean 9.8 months). Patients in ORA group had better results in functional and pain scores in the first three months, with similar results at the final follow-up.
Conclusion
In summary, ORA debridement provides a quicker recovery compared with PTA debridement for one- or two-level LVO. As for the infection control and fusion rate, both debridement approaches had similar results.
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W.L and Y.O. conceived and designed the study. X.D collected the data. X.D. and B.W. analyzed the data. B.W. performed the statistical analyses. W.L. wrote the manuscript. All authors reviewed and revised the manuscript.
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This study was approved by the Institutional Review Board of The First Affiliated Hospital of Chongqing Medical University.
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Luo, W., Ou, Ys., Du, X. et al. Anterior oblique retroperitoneal approach vs posterior transpedicular approach for the treatment of one- or two-level lumbar vertebral osteomyelitis: a retrospective cohort study. International Orthopaedics (SICOT) 44, 2349–2356 (2020). https://doi.org/10.1007/s00264-020-04650-6
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DOI: https://doi.org/10.1007/s00264-020-04650-6