Clinical efficacies of the minimal retroperitoneal approach for infectious spondylodiscitis: A clinical case series

Tsunehiko Konomi, Shinjiro Kaneko, Amir Fariz Zakaria, Kanehiro Fujiyoshi, Junichi Yamane, Takashi Asazuma, Yoshiyuki Yato

研究成果: Article査読

抄録

Introduction: An anterior surgical approach for severe infectious spondylodiscitis in the lumbar region is optimal but not always atraumatic. The aim of this study was to evaluate the efficacy and safety of a minimal anterior-lateral retroperitoneal approach, also known as a surgical approach for oblique lumbar interbody fusion, for cases with severe infectious spondylodiscitis with osseous defects. Methods: Twenty-four consecutive patients who underwent anterior debridement and spinal fusion with an autologous strut bone graft for infectious spondylodiscitis with osseous defects were reviewed retrospectively. Eleven patients underwent the minimal retroperitoneal approach (Group M), and 13 underwent the conventional open approach (Group C). Periand postoperative clinical outcomes, that is, estimated blood loss (EBL), operative time (OT), creatine kinase (CK) level, visual analog scale (VAS), and rates of bone union and additional posterior instrumentation, were evaluated, and the differences between both groups were assessed statistically. Results: Mean EBL, serum CK on the 1st postoperative day, and VAS on the 14th postoperative day were 202.1 mL, 390.9 IU/L, and 9.5 mm in Group M and 648.3 mL, 925.5 IU/L, and 22.3 mm in Group C, respectively, with statistically significant differences between the groups. There were no statistically significant intergroup differences in OT and rates of bone union and additional posterior instrumentation. Conclusions: Anterior debridement and spinal fusion using the minimal retroperitoneal approach is a useful and safe surgical technique. Although a preponderance of the minimal approach regarding early bone union is not validated, this technique has the advantages of conventional open surgery, but reduces blood loss, muscle injury, and pain postoperatively.

本文言語English
ページ(範囲)176-181
ページ数6
ジャーナルSpine Surgery and Related Research
5
3
DOI
出版ステータスPublished - 2021

All Science Journal Classification (ASJC) codes

  • 外科
  • 整形外科およびスポーツ医学
  • 臨床神経学

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