A Minimally Invasive Endoscopic Surgery for Infectious Spondylodiscitis of the Thoracic and Upper Lumbar Spine in Immunocompromised Patients
This study evaluates the safety and effectiveness of computed tomography- (CT-) assisted endoscopic surgery in the treatment of infectious spondylodiscitis of the thoracic and upper lumbar spine in immunocompromised patients. From October 2006 to March 2014, a total of 41 patients with infectious sp...
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| Veröffentlicht in: | BioMed research international 2015-01, Vol.2015 (2015), p.1-8 |
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| creator | Chen, Hsien-Te Hsu, Horng-Chaung Hung, Chih-Hung Lin, Wei-Ching Tsou, Hsi-Kai Chen, Yen-Jen Huang, Teng-Le Chen, Hsin-Chuan Tsai, Chun-Hao |
| description | This study evaluates the safety and effectiveness of computed tomography- (CT-) assisted endoscopic surgery in the treatment of infectious spondylodiscitis of the thoracic and upper lumbar spine in immunocompromised patients. From October 2006 to March 2014, a total of 41 patients with infectious spondylodiscitis underwent percutaneous endoscopic surgery under local anesthesia, and 13 lesions from 13 patients on the thoracic or upper lumbar spine were selected for evaluation. A CT-guided catheter was placed before percutaneous endoscopic surgery as a guide to avoid injury to visceral organs, major vessels, and the spinal cord. All 13 patients had quick pain relief after endoscopic surgery without complications. The bacterial culture rate was 77%. Inflammatory parameters returned to normal after adequate antibiotic treatment. Postoperative radiographs showed no significant kyphotic deformity when compared with preoperative films. As of the last follow-up visit, no recurrent infections were noted. Traditional transthoracic or diaphragmatic surgery with or without posterior instrumentation is associated with high rates of morbidity and mortality, especially in elderly patients, patients with multiple comorbidities, or immunocompromised patients. Percutaneous endoscopic surgery assisted by a CT-guided catheter provides a safe and effective alternative treatment for infectious spondylodiscitis of the thoracic and upper lumbar spine. |
| doi_str_mv | 10.1155/2015/780451 |
| format | Article |
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From October 2006 to March 2014, a total of 41 patients with infectious spondylodiscitis underwent percutaneous endoscopic surgery under local anesthesia, and 13 lesions from 13 patients on the thoracic or upper lumbar spine were selected for evaluation. A CT-guided catheter was placed before percutaneous endoscopic surgery as a guide to avoid injury to visceral organs, major vessels, and the spinal cord. All 13 patients had quick pain relief after endoscopic surgery without complications. The bacterial culture rate was 77%. Inflammatory parameters returned to normal after adequate antibiotic treatment. Postoperative radiographs showed no significant kyphotic deformity when compared with preoperative films. As of the last follow-up visit, no recurrent infections were noted. Traditional transthoracic or diaphragmatic surgery with or without posterior instrumentation is associated with high rates of morbidity and mortality, especially in elderly patients, patients with multiple comorbidities, or immunocompromised patients. Percutaneous endoscopic surgery assisted by a CT-guided catheter provides a safe and effective alternative treatment for infectious spondylodiscitis of the thoracic and upper lumbar spine.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2015/780451</identifier><identifier>PMID: 26273644</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Aged ; Aged, 80 and over ; Bacterial Infections - immunology ; Bacterial Infections - pathology ; Bacterial Infections - surgery ; Biomedical research ; Care and treatment ; Clinical Study ; Discitis - immunology ; Discitis - pathology ; Discitis - surgery ; Endoscopy ; Endoscopy - adverse effects ; Endoscopy - methods ; Female ; Health aspects ; Humans ; Immunocompromised host ; Immunocompromised Host - immunology ; Infection ; Lumbar Vertebrae - surgery ; Male ; Methods ; Middle Aged ; Minimally Invasive Surgical Procedures - adverse effects ; Minimally Invasive Surgical Procedures - methods ; Spinal diseases ; Surgery, Computer-Assisted - methods</subject><ispartof>BioMed research international, 2015-01, Vol.2015 (2015), p.1-8</ispartof><rights>Copyright © 2015 Hsin-Chuan Chen et al.</rights><rights>COPYRIGHT 2015 John Wiley & Sons, Inc.</rights><rights>Copyright © 2015 Hsin-Chuan Chen et al. Hsin-Chuan Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2015 Hsin-Chuan Chen et al. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c594t-eaadb8839915272d60e544ebb9481d4bb6cd2aa222a012687926c6a8a46a40d73</citedby><cites>FETCH-LOGICAL-c594t-eaadb8839915272d60e544ebb9481d4bb6cd2aa222a012687926c6a8a46a40d73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529934/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529934/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26273644$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Liu, Yi</contributor><creatorcontrib>Chen, Hsien-Te</creatorcontrib><creatorcontrib>Hsu, Horng-Chaung</creatorcontrib><creatorcontrib>Hung, Chih-Hung</creatorcontrib><creatorcontrib>Lin, Wei-Ching</creatorcontrib><creatorcontrib>Tsou, Hsi-Kai</creatorcontrib><creatorcontrib>Chen, Yen-Jen</creatorcontrib><creatorcontrib>Huang, Teng-Le</creatorcontrib><creatorcontrib>Chen, Hsin-Chuan</creatorcontrib><creatorcontrib>Tsai, Chun-Hao</creatorcontrib><title>A Minimally Invasive Endoscopic Surgery for Infectious Spondylodiscitis of the Thoracic and Upper Lumbar Spine in Immunocompromised Patients</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>This study evaluates the safety and effectiveness of computed tomography- (CT-) assisted endoscopic surgery in the treatment of infectious spondylodiscitis of the thoracic and upper lumbar spine in immunocompromised patients. From October 2006 to March 2014, a total of 41 patients with infectious spondylodiscitis underwent percutaneous endoscopic surgery under local anesthesia, and 13 lesions from 13 patients on the thoracic or upper lumbar spine were selected for evaluation. A CT-guided catheter was placed before percutaneous endoscopic surgery as a guide to avoid injury to visceral organs, major vessels, and the spinal cord. All 13 patients had quick pain relief after endoscopic surgery without complications. The bacterial culture rate was 77%. Inflammatory parameters returned to normal after adequate antibiotic treatment. Postoperative radiographs showed no significant kyphotic deformity when compared with preoperative films. As of the last follow-up visit, no recurrent infections were noted. Traditional transthoracic or diaphragmatic surgery with or without posterior instrumentation is associated with high rates of morbidity and mortality, especially in elderly patients, patients with multiple comorbidities, or immunocompromised patients. Percutaneous endoscopic surgery assisted by a CT-guided catheter provides a safe and effective alternative treatment for infectious spondylodiscitis of the thoracic and upper lumbar spine.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bacterial Infections - immunology</subject><subject>Bacterial Infections - pathology</subject><subject>Bacterial Infections - surgery</subject><subject>Biomedical research</subject><subject>Care and treatment</subject><subject>Clinical Study</subject><subject>Discitis - immunology</subject><subject>Discitis - pathology</subject><subject>Discitis - surgery</subject><subject>Endoscopy</subject><subject>Endoscopy - adverse effects</subject><subject>Endoscopy - methods</subject><subject>Female</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Immunocompromised host</subject><subject>Immunocompromised Host - immunology</subject><subject>Infection</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - adverse effects</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Spinal diseases</subject><subject>Surgery, Computer-Assisted - methods</subject><issn>2314-6133</issn><issn>2314-6141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNks9rFDEUxwdRbKk9eZeAF6msze9JLsJSqi6sKLQ9h0yS2U2ZScZkZmX_B_9oM2xdq6fmksD7vO_Le-9bVa8R_IAQY5cYInZZC0gZeladYoLogiOKnh_fhJxU5znfw3IE4lDyl9UJ5rgmnNLT6tcSfPXB97rr9mAVdjr7nQPXwcZs4uANuJnSxqU9aGMq8daZ0ccpg5shBrvvovXZ-NFnEFswbh243cakTcnTwYK7YXAJrKe-0alk-OCAD2DV91OIJvZDir3PzoLvevQujPlV9aLVXXbnD_dZdffp-vbqy2L97fPqarleGCbpuHBa20YIIiViuMaWQ8codU0jqUCWNg03FmuNMdYQYS5qibnhWmjKNYW2JmfVx4PuMDW9s6bUTrpTQypzSHsVtVf_RoLfqk3cKcqwlIQWgXcPAin-mFweVWnEuK7TwZXpKFRDiQSXon4KSgmjAsqCvv0PvY9TCmUSM1V2BkvHf6mN7pzyoY3li2YWVUvKyooJ5nPZ9wfKpJhzcu2xOwTV7Bw1O0cdnFPoN48HcmT_-KQAFwdg64PVP_3T1FxBXKsfwYxzSchv-wHVJQ</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Chen, Hsien-Te</creator><creator>Hsu, Horng-Chaung</creator><creator>Hung, Chih-Hung</creator><creator>Lin, Wei-Ching</creator><creator>Tsou, Hsi-Kai</creator><creator>Chen, Yen-Jen</creator><creator>Huang, Teng-Le</creator><creator>Chen, Hsin-Chuan</creator><creator>Tsai, Chun-Hao</creator><general>Hindawi Publishing Corporation</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><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>3V.</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>CWDGH</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150101</creationdate><title>A Minimally Invasive Endoscopic Surgery for Infectious Spondylodiscitis of the Thoracic and Upper Lumbar Spine in Immunocompromised Patients</title><author>Chen, Hsien-Te ; Hsu, Horng-Chaung ; Hung, Chih-Hung ; Lin, Wei-Ching ; Tsou, Hsi-Kai ; Chen, Yen-Jen ; Huang, Teng-Le ; Chen, Hsin-Chuan ; Tsai, Chun-Hao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c594t-eaadb8839915272d60e544ebb9481d4bb6cd2aa222a012687926c6a8a46a40d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bacterial Infections - immunology</topic><topic>Bacterial Infections - pathology</topic><topic>Bacterial Infections - surgery</topic><topic>Biomedical research</topic><topic>Care and treatment</topic><topic>Clinical Study</topic><topic>Discitis - immunology</topic><topic>Discitis - pathology</topic><topic>Discitis - surgery</topic><topic>Endoscopy</topic><topic>Endoscopy - adverse effects</topic><topic>Endoscopy - methods</topic><topic>Female</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Immunocompromised host</topic><topic>Immunocompromised Host - immunology</topic><topic>Infection</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Male</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - adverse effects</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Spinal diseases</topic><topic>Surgery, Computer-Assisted - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Hsien-Te</creatorcontrib><creatorcontrib>Hsu, Horng-Chaung</creatorcontrib><creatorcontrib>Hung, Chih-Hung</creatorcontrib><creatorcontrib>Lin, Wei-Ching</creatorcontrib><creatorcontrib>Tsou, Hsi-Kai</creatorcontrib><creatorcontrib>Chen, Yen-Jen</creatorcontrib><creatorcontrib>Huang, Teng-Le</creatorcontrib><creatorcontrib>Chen, Hsin-Chuan</creatorcontrib><creatorcontrib>Tsai, Chun-Hao</creatorcontrib><collection>الدوريات العلمية والإحصائية - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BioMed research international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Hsien-Te</au><au>Hsu, Horng-Chaung</au><au>Hung, Chih-Hung</au><au>Lin, Wei-Ching</au><au>Tsou, Hsi-Kai</au><au>Chen, Yen-Jen</au><au>Huang, Teng-Le</au><au>Chen, Hsin-Chuan</au><au>Tsai, Chun-Hao</au><au>Liu, Yi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Minimally Invasive Endoscopic Surgery for Infectious Spondylodiscitis of the Thoracic and Upper Lumbar Spine in Immunocompromised Patients</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>2015</volume><issue>2015</issue><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract>This study evaluates the safety and effectiveness of computed tomography- (CT-) assisted endoscopic surgery in the treatment of infectious spondylodiscitis of the thoracic and upper lumbar spine in immunocompromised patients. From October 2006 to March 2014, a total of 41 patients with infectious spondylodiscitis underwent percutaneous endoscopic surgery under local anesthesia, and 13 lesions from 13 patients on the thoracic or upper lumbar spine were selected for evaluation. A CT-guided catheter was placed before percutaneous endoscopic surgery as a guide to avoid injury to visceral organs, major vessels, and the spinal cord. All 13 patients had quick pain relief after endoscopic surgery without complications. The bacterial culture rate was 77%. Inflammatory parameters returned to normal after adequate antibiotic treatment. Postoperative radiographs showed no significant kyphotic deformity when compared with preoperative films. As of the last follow-up visit, no recurrent infections were noted. Traditional transthoracic or diaphragmatic surgery with or without posterior instrumentation is associated with high rates of morbidity and mortality, especially in elderly patients, patients with multiple comorbidities, or immunocompromised patients. Percutaneous endoscopic surgery assisted by a CT-guided catheter provides a safe and effective alternative treatment for infectious spondylodiscitis of the thoracic and upper lumbar spine.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>26273644</pmid><doi>10.1155/2015/780451</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Bacterial Infections - immunology Bacterial Infections - pathology Bacterial Infections - surgery Biomedical research Care and treatment Clinical Study Discitis - immunology Discitis - pathology Discitis - surgery Endoscopy Endoscopy - adverse effects Endoscopy - methods Female Health aspects Humans Immunocompromised host Immunocompromised Host - immunology Infection Lumbar Vertebrae - surgery Male Methods Middle Aged Minimally Invasive Surgical Procedures - adverse effects Minimally Invasive Surgical Procedures - methods Spinal diseases Surgery, Computer-Assisted - methods |
| title | A Minimally Invasive Endoscopic Surgery for Infectious Spondylodiscitis of the Thoracic and Upper Lumbar Spine in Immunocompromised Patients |
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