Transpedicular curettage and drainage of infective lumbar spondylodiscitis

Technique and clinical results

Byung Ho Lee, Hwan Mo Lee, Tae Hwan Kim, Hak Sun Kim, Eun Soo Moon, Jin Oh Park, Hyun Soo Chong, seonghwan moon

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Infective spondylodiscitis usually occurs in patients of older age, immunocompromisation, co-morbidity, and individuals suffering from an overall poor general condition unable to undergo reconstructive anterior and posterior surgeries. Therefore, an alternative, less aggressive surgical method is needed for these select cases of infective spondylodiscitis. This retrospective clinical case series reports our novel surgical technique for the treatment of infective spondylodiscitis. Methods: Between January 2005 and July 2011, among 48 patients who were diagnosed with pyogenic lumbar spondylodiscitis or tuberculosis lumbar spondylodiscitis, 10 patients (7 males and 3 females; 68 years and 48 to 78 years, respectively) underwent transpedicular curettage and drainage. The mean postoperative follow-up period was 29 months (range, 7 to 61 months). The pedicle screws were inserted to the adjacent healthy vertebrae in the usual manner. After insertion of pedicle screws, the drainage pedicle holes were made through pedicles of infected vertebra(e) in order to prevent possible seeding of infective emboli to the healthy vertebra, as the same instruments and utensils are used for both pedicle screws and the drainage holes. A minimum of 15,000 mL of sterilized normal saline was used for continuous irrigation through the pedicular pathways until the drained fluid looked clear. Results: All patients' symptoms and inflammatory markers significantly improved clinically between postoperative 2 weeks and postoperative 3 months, and they were satisfied with their clinical results. Radiologically, all patients reached the spontaneous fusion between infected vertebrae and 3 patients had the screw pulled-out but they were clinically tolerable. Conclusions: We suggest that our method of transpedicular curettage and drainage is a useful technique in regards to the treatment of infectious spondylodiscitic patients, who could not tolerate conventional combined anterior and posterior surgery due to multiple co-morbidities, multiple level infectious lesions and poor general condition.

Original languageEnglish
Pages (from-to)200-208
Number of pages9
JournalClinics in Orthopedic Surgery
Volume4
Issue number3
DOIs
Publication statusPublished - 2012 Sep 1

Fingerprint

Discitis
Curettage
Drainage
Spine
Phthiraptera
Morbidity
Embolism
Tuberculosis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Lee, Byung Ho ; Lee, Hwan Mo ; Kim, Tae Hwan ; Kim, Hak Sun ; Moon, Eun Soo ; Park, Jin Oh ; Chong, Hyun Soo ; moon, seonghwan. / Transpedicular curettage and drainage of infective lumbar spondylodiscitis : Technique and clinical results. In: Clinics in Orthopedic Surgery. 2012 ; Vol. 4, No. 3. pp. 200-208.
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Transpedicular curettage and drainage of infective lumbar spondylodiscitis : Technique and clinical results. / Lee, Byung Ho; Lee, Hwan Mo; Kim, Tae Hwan; Kim, Hak Sun; Moon, Eun Soo; Park, Jin Oh; Chong, Hyun Soo; moon, seonghwan.

In: Clinics in Orthopedic Surgery, Vol. 4, No. 3, 01.09.2012, p. 200-208.

Research output: Contribution to journalArticle

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AU - Lee, Byung Ho

AU - Lee, Hwan Mo

AU - Kim, Tae Hwan

AU - Kim, Hak Sun

AU - Moon, Eun Soo

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AU - moon, seonghwan

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