One-stage Surgical Management for Lumbar Brucella Spondylitis by Posterior Debridement, Autogenous Bone Graft and Instrumentation: A Case Series of 24 Patients
Clinical case series. The aim of this study was to explore the efficacy and safety of one-stage debridement, autogenous bone graft, and instrumentation for lumbar brucella spondylitis (LBS) via a posterior approach. Reports on LBS are sporadic, and the therapeutic effect and safety of surgical inter...
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| Veröffentlicht in: | Spine (Philadelphia, Pa. 1976) Pa. 1976), 2017-10, Vol.42 (19), p.E1112-E1118 |
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| creator | Chen, Yangbin Yang, Jun-Song Li, Tao Liu, Peng Liu, Tuan-Jiang He, Li-Min Qian, Li-Xiong Hao, Ding-Jun |
| description | Clinical case series.
The aim of this study was to explore the efficacy and safety of one-stage debridement, autogenous bone graft, and instrumentation for lumbar brucella spondylitis (LBS) via a posterior approach.
Reports on LBS are sporadic, and the therapeutic effect and safety of surgical interventions have not been assessed in clinical studies.
Between January 2012 and January 2014, 24 consecutive patients with symptomatic LBS who underwent a one-stage operation that combined debridement, autogenous bone graft, and instrumentation via a posterior approach were enrolled. Back pain was measured using the visual analog scale (VAS). The neurological status was evaluated with the American Spinal Injury Association (ASIA) scale. Bone healing was evaluated based on postoperative plain x-ray or computed tomography.
All cases were followed up for an average of 14.3 + 3.5 months. The VAS scores were significantly improved at every follow-up interval. An improvement of at least one grade level was observed in the ASIA score of each patient. The average time of bone fusion was 6.8 + 1.6 months. Significant improvements of the average segmental Cobb angle was observed from a preoperative value of 18.4° + 4.6° to a last follow-up value of 21.1° ± 3.7°. At the last follow up, the titers of antibodies against the standard tube agglutination test, erythrocyte sedimentation rate, and C-reactive protein were negative for all patients.
For LBS, systemic antibrucellosis chemotherapy is the cornerstone of treatment. When cauda equine syndrome, radiculopathy, spinal instability, and severe back pain caused by extradural nonabsorbable abscess or progressive collapse are present, surgical intervention is inevitable. One-stage debridement, autogenous bone graft, and instrumentation via a posterior approach could represent an alternative treatment for LBS, and the efficacy and safety of these techniques are satisfactory.
4. |
| doi_str_mv | 10.1097/BRS.0000000000002093 |
| format | Article |
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The aim of this study was to explore the efficacy and safety of one-stage debridement, autogenous bone graft, and instrumentation for lumbar brucella spondylitis (LBS) via a posterior approach.
Reports on LBS are sporadic, and the therapeutic effect and safety of surgical interventions have not been assessed in clinical studies.
Between January 2012 and January 2014, 24 consecutive patients with symptomatic LBS who underwent a one-stage operation that combined debridement, autogenous bone graft, and instrumentation via a posterior approach were enrolled. Back pain was measured using the visual analog scale (VAS). The neurological status was evaluated with the American Spinal Injury Association (ASIA) scale. Bone healing was evaluated based on postoperative plain x-ray or computed tomography.
All cases were followed up for an average of 14.3 + 3.5 months. The VAS scores were significantly improved at every follow-up interval. An improvement of at least one grade level was observed in the ASIA score of each patient. The average time of bone fusion was 6.8 + 1.6 months. Significant improvements of the average segmental Cobb angle was observed from a preoperative value of 18.4° + 4.6° to a last follow-up value of 21.1° ± 3.7°. At the last follow up, the titers of antibodies against the standard tube agglutination test, erythrocyte sedimentation rate, and C-reactive protein were negative for all patients.
For LBS, systemic antibrucellosis chemotherapy is the cornerstone of treatment. When cauda equine syndrome, radiculopathy, spinal instability, and severe back pain caused by extradural nonabsorbable abscess or progressive collapse are present, surgical intervention is inevitable. One-stage debridement, autogenous bone graft, and instrumentation via a posterior approach could represent an alternative treatment for LBS, and the efficacy and safety of these techniques are satisfactory.
4.</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/BRS.0000000000002093</identifier><identifier>PMID: 28157811</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Aged ; Bone Transplantation - methods ; Brucella ; Brucellosis - diagnostic imaging ; Brucellosis - surgery ; Debridement - methods ; Disease Management ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae - diagnostic imaging ; Lumbar Vertebrae - microbiology ; Lumbar Vertebrae - surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures - methods ; Retrospective Studies ; Spondylitis - diagnostic imaging ; Spondylitis - microbiology ; Spondylitis - surgery ; Treatment Outcome</subject><ispartof>Spine (Philadelphia, Pa. 1976), 2017-10, Vol.42 (19), p.E1112-E1118</ispartof><rights>Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3017-d7d3a3899b7c3bc3bf4cf10988a35afbe1a90495b20b807f12503357f1e0126b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28157811$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Yangbin</creatorcontrib><creatorcontrib>Yang, Jun-Song</creatorcontrib><creatorcontrib>Li, Tao</creatorcontrib><creatorcontrib>Liu, Peng</creatorcontrib><creatorcontrib>Liu, Tuan-Jiang</creatorcontrib><creatorcontrib>He, Li-Min</creatorcontrib><creatorcontrib>Qian, Li-Xiong</creatorcontrib><creatorcontrib>Hao, Ding-Jun</creatorcontrib><title>One-stage Surgical Management for Lumbar Brucella Spondylitis by Posterior Debridement, Autogenous Bone Graft and Instrumentation: A Case Series of 24 Patients</title><title>Spine (Philadelphia, Pa. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><description>Clinical case series.
The aim of this study was to explore the efficacy and safety of one-stage debridement, autogenous bone graft, and instrumentation for lumbar brucella spondylitis (LBS) via a posterior approach.
Reports on LBS are sporadic, and the therapeutic effect and safety of surgical interventions have not been assessed in clinical studies.
Between January 2012 and January 2014, 24 consecutive patients with symptomatic LBS who underwent a one-stage operation that combined debridement, autogenous bone graft, and instrumentation via a posterior approach were enrolled. Back pain was measured using the visual analog scale (VAS). The neurological status was evaluated with the American Spinal Injury Association (ASIA) scale. Bone healing was evaluated based on postoperative plain x-ray or computed tomography.
All cases were followed up for an average of 14.3 + 3.5 months. The VAS scores were significantly improved at every follow-up interval. An improvement of at least one grade level was observed in the ASIA score of each patient. The average time of bone fusion was 6.8 + 1.6 months. Significant improvements of the average segmental Cobb angle was observed from a preoperative value of 18.4° + 4.6° to a last follow-up value of 21.1° ± 3.7°. At the last follow up, the titers of antibodies against the standard tube agglutination test, erythrocyte sedimentation rate, and C-reactive protein were negative for all patients.
For LBS, systemic antibrucellosis chemotherapy is the cornerstone of treatment. When cauda equine syndrome, radiculopathy, spinal instability, and severe back pain caused by extradural nonabsorbable abscess or progressive collapse are present, surgical intervention is inevitable. One-stage debridement, autogenous bone graft, and instrumentation via a posterior approach could represent an alternative treatment for LBS, and the efficacy and safety of these techniques are satisfactory.
4.</description><subject>Adult</subject><subject>Aged</subject><subject>Bone Transplantation - methods</subject><subject>Brucella</subject><subject>Brucellosis - diagnostic imaging</subject><subject>Brucellosis - surgery</subject><subject>Debridement - methods</subject><subject>Disease Management</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Lumbar Vertebrae - microbiology</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Retrospective Studies</subject><subject>Spondylitis - diagnostic imaging</subject><subject>Spondylitis - microbiology</subject><subject>Spondylitis - surgery</subject><subject>Treatment Outcome</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUdtuEzEUtBCIhsIfIHQeeWCLL-u98JYEKJWCWhF4Xtm7x-nCrp36oipfw6_ipuUiLEs-tmfmaM4Q8pLRM0bb-u3qy_aM_rM4bcUjsmCSNwVjsn1MFlRUvOClqE7IsxC-Z1AlWPuUnPCGybphbEF-XlosQlQ7hG3yu7FXE3xWNt9ntBGM87BJs1YeVj71OE0Ktntnh8M0xjGAPsCVCxH9mIHvUftxOBLfwDJFt0PrUoCVswjnXpkIyg5wYUP06Q6l4ujsO1jCWoXcP6tgAGeAl3CV_zIiPCdPjJoCvng4T8m3jx--rj8Vm8vzi_VyU_SCsroY6kEo0bStrnuh8zZlb_KYmkYJqYxGplpatlJzqhtaG8YlFULmAinjlRan5PW97t67m4QhdvMYjn4tZg8dayopZU25zNDyHtp7F4JH0-39OCt_6Bjt7qLpcjTd_9Fk2quHDknPOPwh_c7ir-6tm_JEw48p3aLvrlFN8fqoV1ci55n9MkoZLY5P4heoiZog</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Chen, Yangbin</creator><creator>Yang, Jun-Song</creator><creator>Li, Tao</creator><creator>Liu, Peng</creator><creator>Liu, Tuan-Jiang</creator><creator>He, Li-Min</creator><creator>Qian, Li-Xiong</creator><creator>Hao, Ding-Jun</creator><general>Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20171001</creationdate><title>One-stage Surgical Management for Lumbar Brucella Spondylitis by Posterior Debridement, Autogenous Bone Graft and Instrumentation: A Case Series of 24 Patients</title><author>Chen, Yangbin ; Yang, Jun-Song ; Li, Tao ; Liu, Peng ; Liu, Tuan-Jiang ; He, Li-Min ; Qian, Li-Xiong ; Hao, Ding-Jun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3017-d7d3a3899b7c3bc3bf4cf10988a35afbe1a90495b20b807f12503357f1e0126b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bone Transplantation - methods</topic><topic>Brucella</topic><topic>Brucellosis - diagnostic imaging</topic><topic>Brucellosis - surgery</topic><topic>Debridement - methods</topic><topic>Disease Management</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Lumbar Vertebrae - microbiology</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Retrospective Studies</topic><topic>Spondylitis - diagnostic imaging</topic><topic>Spondylitis - microbiology</topic><topic>Spondylitis - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Yangbin</creatorcontrib><creatorcontrib>Yang, Jun-Song</creatorcontrib><creatorcontrib>Li, Tao</creatorcontrib><creatorcontrib>Liu, Peng</creatorcontrib><creatorcontrib>Liu, Tuan-Jiang</creatorcontrib><creatorcontrib>He, Li-Min</creatorcontrib><creatorcontrib>Qian, Li-Xiong</creatorcontrib><creatorcontrib>Hao, Ding-Jun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Yangbin</au><au>Yang, Jun-Song</au><au>Li, Tao</au><au>Liu, Peng</au><au>Liu, Tuan-Jiang</au><au>He, Li-Min</au><au>Qian, Li-Xiong</au><au>Hao, Ding-Jun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>One-stage Surgical Management for Lumbar Brucella Spondylitis by Posterior Debridement, Autogenous Bone Graft and Instrumentation: A Case Series of 24 Patients</atitle><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>42</volume><issue>19</issue><spage>E1112</spage><epage>E1118</epage><pages>E1112-E1118</pages><issn>0362-2436</issn><eissn>1528-1159</eissn><abstract>Clinical case series.
The aim of this study was to explore the efficacy and safety of one-stage debridement, autogenous bone graft, and instrumentation for lumbar brucella spondylitis (LBS) via a posterior approach.
Reports on LBS are sporadic, and the therapeutic effect and safety of surgical interventions have not been assessed in clinical studies.
Between January 2012 and January 2014, 24 consecutive patients with symptomatic LBS who underwent a one-stage operation that combined debridement, autogenous bone graft, and instrumentation via a posterior approach were enrolled. Back pain was measured using the visual analog scale (VAS). The neurological status was evaluated with the American Spinal Injury Association (ASIA) scale. Bone healing was evaluated based on postoperative plain x-ray or computed tomography.
All cases were followed up for an average of 14.3 + 3.5 months. The VAS scores were significantly improved at every follow-up interval. An improvement of at least one grade level was observed in the ASIA score of each patient. The average time of bone fusion was 6.8 + 1.6 months. Significant improvements of the average segmental Cobb angle was observed from a preoperative value of 18.4° + 4.6° to a last follow-up value of 21.1° ± 3.7°. At the last follow up, the titers of antibodies against the standard tube agglutination test, erythrocyte sedimentation rate, and C-reactive protein were negative for all patients.
For LBS, systemic antibrucellosis chemotherapy is the cornerstone of treatment. When cauda equine syndrome, radiculopathy, spinal instability, and severe back pain caused by extradural nonabsorbable abscess or progressive collapse are present, surgical intervention is inevitable. One-stage debridement, autogenous bone graft, and instrumentation via a posterior approach could represent an alternative treatment for LBS, and the efficacy and safety of these techniques are satisfactory.
4.</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>28157811</pmid><doi>10.1097/BRS.0000000000002093</doi></addata></record> |
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| identifier | ISSN: 0362-2436 |
| ispartof | Spine (Philadelphia, Pa. 1976), 2017-10, Vol.42 (19), p.E1112-E1118 |
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| subjects | Adult Aged Bone Transplantation - methods Brucella Brucellosis - diagnostic imaging Brucellosis - surgery Debridement - methods Disease Management Female Follow-Up Studies Humans Lumbar Vertebrae - diagnostic imaging Lumbar Vertebrae - microbiology Lumbar Vertebrae - surgery Male Middle Aged Reconstructive Surgical Procedures - methods Retrospective Studies Spondylitis - diagnostic imaging Spondylitis - microbiology Spondylitis - surgery Treatment Outcome |
| title | One-stage Surgical Management for Lumbar Brucella Spondylitis by Posterior Debridement, Autogenous Bone Graft and Instrumentation: A Case Series of 24 Patients |
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