Analysis of Safety and Efficacy of Unilateral Biportal Endoscopy Combined With Oblique Lumbar Interbody Fusion in the Treatment of Lumbar Infectious Spondylitis.

Abstract

Study design: Retrospective case series.

Objective: To explore the clinical efficacy and safety of unilateral biportal endoscopy (UBE) combined with oblique lumbar interbody fusion (OLIF) in the treatment of lumbar infectious spondylitis (LIS).

Background: In recent years, there has been a notable increase in the incidence of LIS. Patients typically present with back pain, tenderness, and stiffness, which may be accompanied by fever, which significantly reduces their quality of life.

Patients and methods: This study selected 25 patients with LIS treated by UBE with OLIF from January 2018 to March 2023 in our hospital, including 14 males and 11 females. During the perioperative phase, key indicators such as white blood cell count, erythrocyte sedimentation rate, and C-reactive protein were monitored to evaluate the efficacy of the infection treatment. Surgical-related indicators and the frequency of complications were systematically recorded. Functional and imaging indicators before and after the operation were compared.

Results: The surgical intervention was successful in all 25 patients. The average operation time was 155.2 ± 23.5 minutes, the average blood loss was 265.6 ± 46.8 mL, and the average follow-up time was 18.8 ± 6.9 months. Bacterial cultures of 12 patients were positive, and postoperative pathologic examination of all patients showed inflammation. Postoperative patients exhibited significant clinical symptom improvement, characterized by a gradual decrease in erythrocyte sedimentation rate, C-reactive protein, and white blood cell count, ultimately returning to normal levels. The Visual Analog Scale scores, Japanese Orthopedic Association scores, and Oswestry Disability Index were significantly improved after the operation (P < 0.001). In addition, the height of the intervertebral space and the angle of lumbar lordosis were optimally restored. At the last follow-up, the fusion rate of bone graft was 96%.

Conclusion: The combined treatment of LIS with UBE and OLIF is effective, thereby establishing itself as an effective, safe, and viable surgical technique.