Treatment of single-segment suppurative spondylitis with the transforaminal endoscopic focal cleaning and drainage

Abstract

Objective: To evaluate the clinical value of the transforaminal endoscopic focal cleaning and drainage for suppurative spondylitis.

Design: Retrospective study.

Participants: Twenty-one patients with single-segment suppurative spondylitis.

Interventions: All patients were treated with the transforaminal endoscopic focal cleaning and drainage.

Outcome Measures: The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured before and after the operation. Visual analogue scale (VAS) was used to evaluate the relief of pain symptoms. Neurological function American Spinal Injury Association (ASIA) grade was used to evaluate the recovery of neurological function. The postoperative clinical efficacy of the patients was evaluated using the Kirkaldy-Willis functional scoring criteria. The stability of the spine and the recurrence of infection were evaluated by imaging data.

Results: Postoperative bacteriological culture results showed positive in 15 cases and no bacteria growth in 6 cases. Besides, 16 cases were pathologically diagnosed. The ESR, CRP, and VAS scores at 2 weeks postoperatively and at the last follow-up were significantly improved compared with those at pre-operation. At the last follow-up, the clinical outcome was excellent in 17 cases, good in 3 cases, and fair in 1 case, according to the Kirkaldy-Willis functional scoring criteria; and the ASIA grade returned to normal. There was no significant difference in the Cobb angle between the last follow-up and the pre-operation. There was no recurrence of infection during the follow-up period.

Conclusion: The transforaminal endoscopic focal cleaning and drainage is a minimally invasive, effective and safe surgical procedure for suppurative spondylitis.

Keywords:

• Suppurative spondylitis
• Endoscopy
• Single-segment
• Infection control
• Clinical efficacy
• Minimally invasive