지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2011.1
- 수록면
- 332 - 340 (9page)
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초록· 키워드
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Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.
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참고문헌 (43)
참고문헌 신청
Barth E / 1989 / In vitro and in vivo comparative colonization of Staphylococcus aureus and Staphylococcus epidermidis on orthopaedic implant materials / Biomaterials 10:325~328
Calderone RR / 1996 / Overview and classification of spinal infections / Orthop Clin North Am 27:1~8
Carragee EJ / 1997 / Instrumentation of the infected and unstable spine : a review of 17 cases from the thoracic and lumbar spine with pyogenic infections / J Spinal Disord 10:317~324
Carragee EJ / 1997 / Pyogenic vertebral osteomyelitis / J Bone Joint Surg Am 79:874~880
Emery SE / 1989 / Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting / Spine (Phila Pa 1976) 14:284~291
Calderone RR / 1996 / Overview and classification of spinal infections / Orthop Clin North Am 27:1~8
Carragee EJ / 1997 / Instrumentation of the infected and unstable spine : a review of 17 cases from the thoracic and lumbar spine with pyogenic infections / J Spinal Disord 10:317~324
Carragee EJ / 1997 / Pyogenic vertebral osteomyelitis / J Bone Joint Surg Am 79:874~880
Emery SE / 1989 / Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting / Spine (Phila Pa 1976) 14:284~291
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