{"title":"通过前路清创、重建和器械植入对颈椎化脓性脊盘炎进行一期手术治疗：单中心经验。","authors":"Shutao Gao, Yukun Hu, Haonan Li, Fulati Mamat, Chuanhui Xun, Weibin Sheng","doi":"10.1016/j.wneu.2024.08.156","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Surgical treatment is an effective strategy for cervical pyogenic spondylodiscitis (CPS). However, the optimal surgical approach is uncertain. This study was conducted to evaluate the clinical efficacy of debridement, reconstruction, and instrumentation via the anterior-only approach for CPS.</p><p><strong>Methods: </strong>We retrospectively collected the data of patients with CPS who underwent one-stage anterior debridement, reconstruction, and instrumentation from January 2013 to December 2022. The surgical duration and blood loss volume were analyzed. The Frankel grading classification was used to evaluate the improvement in neurological function. The visual analog scale and Japanese Orthopaedic Association scores were used to evaluate neck pain and functional recovery. The radiological parameters of regional lordosis angle and C2-C7 Cobb angle were used to evaluate the recovery of cervical alignment. C-reactive protein and erythrocyte sedimentation rate were evaluated to assess the control of infection.</p><p><strong>Results: </strong>Totally, 32 patients were eligible. The surgical duration was 118.9 ± 14.3 minutes, and the blood loss volume was 88.4 ± 42.7 mL. Significant improvements in the Frankel grading were observed in patients with neurological deficits. The visual analog scale and Japanese Orthopaedic Association scores significantly improved postoperatively and during follow-up (P < 0.01). The regional lordosis angle significantly increased from 4.0° ± 6.6° preoperatively to 8.4° ± 5.8° at the final follow-up (P < 0.01). The C2-C7 Cobb angle increased from 11.1° ± 7.1° preoperatively to 13.8° ± 7.2° at the final follow-up (P < 0.01). Bony fusion occurred in all patients. C-reactive protein and erythrocyte sedimentation rate significantly decreased postoperatively and returned to normal during follow-up.</p><p><strong>Conclusions: </strong>One-stage debridement, reconstruction, and instrumentation via the anterior approach is an effective surgical strategy for CPS. In addition to surgery, targeted and prolonged antibiotic therapy is of crucial importance.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"One-Stage Surgical Management for Cervical Pyogenic Spondylodiscitis by Anterior Debridement, Reconstruction, and Instrumentation: A Single-Center Experience.\",\"authors\":\"Shutao Gao, Yukun Hu, Haonan Li, Fulati Mamat, Chuanhui Xun, Weibin Sheng\",\"doi\":\"10.1016/j.wneu.2024.08.156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Surgical treatment is an effective strategy for cervical pyogenic spondylodiscitis (CPS). However, the optimal surgical approach is uncertain. This study was conducted to evaluate the clinical efficacy of debridement, reconstruction, and instrumentation via the anterior-only approach for CPS.</p><p><strong>Methods: </strong>We retrospectively collected the data of patients with CPS who underwent one-stage anterior debridement, reconstruction, and instrumentation from January 2013 to December 2022. The surgical duration and blood loss volume were analyzed. The Frankel grading classification was used to evaluate the improvement in neurological function. The visual analog scale and Japanese Orthopaedic Association scores were used to evaluate neck pain and functional recovery. The radiological parameters of regional lordosis angle and C2-C7 Cobb angle were used to evaluate the recovery of cervical alignment. C-reactive protein and erythrocyte sedimentation rate were evaluated to assess the control of infection.</p><p><strong>Results: </strong>Totally, 32 patients were eligible. The surgical duration was 118.9 ± 14.3 minutes, and the blood loss volume was 88.4 ± 42.7 mL. Significant improvements in the Frankel grading were observed in patients with neurological deficits. The visual analog scale and Japanese Orthopaedic Association scores significantly improved postoperatively and during follow-up (P < 0.01). The regional lordosis angle significantly increased from 4.0° ± 6.6° preoperatively to 8.4° ± 5.8° at the final follow-up (P < 0.01). The C2-C7 Cobb angle increased from 11.1° ± 7.1° preoperatively to 13.8° ± 7.2° at the final follow-up (P < 0.01). Bony fusion occurred in all patients. C-reactive protein and erythrocyte sedimentation rate significantly decreased postoperatively and returned to normal during follow-up.</p><p><strong>Conclusions: </strong>One-stage debridement, reconstruction, and instrumentation via the anterior approach is an effective surgical strategy for CPS. In addition to surgery, targeted and prolonged antibiotic therapy is of crucial importance.</p>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2024-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2024.08.156\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.08.156","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
One-Stage Surgical Management for Cervical Pyogenic Spondylodiscitis by Anterior Debridement, Reconstruction, and Instrumentation: A Single-Center Experience.
Objective: Surgical treatment is an effective strategy for cervical pyogenic spondylodiscitis (CPS). However, the optimal surgical approach is uncertain. This study was conducted to evaluate the clinical efficacy of debridement, reconstruction, and instrumentation via the anterior-only approach for CPS.
Methods: We retrospectively collected the data of patients with CPS who underwent one-stage anterior debridement, reconstruction, and instrumentation from January 2013 to December 2022. The surgical duration and blood loss volume were analyzed. The Frankel grading classification was used to evaluate the improvement in neurological function. The visual analog scale and Japanese Orthopaedic Association scores were used to evaluate neck pain and functional recovery. The radiological parameters of regional lordosis angle and C2-C7 Cobb angle were used to evaluate the recovery of cervical alignment. C-reactive protein and erythrocyte sedimentation rate were evaluated to assess the control of infection.
Results: Totally, 32 patients were eligible. The surgical duration was 118.9 ± 14.3 minutes, and the blood loss volume was 88.4 ± 42.7 mL. Significant improvements in the Frankel grading were observed in patients with neurological deficits. The visual analog scale and Japanese Orthopaedic Association scores significantly improved postoperatively and during follow-up (P < 0.01). The regional lordosis angle significantly increased from 4.0° ± 6.6° preoperatively to 8.4° ± 5.8° at the final follow-up (P < 0.01). The C2-C7 Cobb angle increased from 11.1° ± 7.1° preoperatively to 13.8° ± 7.2° at the final follow-up (P < 0.01). Bony fusion occurred in all patients. C-reactive protein and erythrocyte sedimentation rate significantly decreased postoperatively and returned to normal during follow-up.
Conclusions: One-stage debridement, reconstruction, and instrumentation via the anterior approach is an effective surgical strategy for CPS. In addition to surgery, targeted and prolonged antibiotic therapy is of crucial importance.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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