Safety and efficacy of percutaneous instrumentation combined with antibiotic treatment in spondylodiscitis - 19/09/19
, Yann Philippe Charles a, Yves Ntilikina a, Nicolas Lefebvre b, Yves Hansmann b, Erik André Sauleau c, Jean-Paul Steib a
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Background |
Patients with spondylodiscitis are treated with antibiotics and braces for 6 to 12 weeks. Braces aim to decrease pain and prevent kyphotic deformity due to vertebral body collapse. Percutaneous instrumentation could be an alternative to influence pain and patient's autonomy.
Purpose |
The purpose of this study was to analyze back pain, quality of life, sagittal deformity, and complications after percutaneous instrumentation in spondylodiscitis.
Patients and methods |
VAS for back pain, EQ-5D, radiographic sagittal index were assessed retrospectively for 28 patients who had a standardized follow-up at 5 days, 6 weeks, 3 months, 1 and 2 years. Probabilities>0.95 indicated significant changes (Bayesian model).
Results |
VAS was 7.0 preoperatively, 3.2 (day 5), 2.2 (6 weeks), 1.9 (3 months), 1.6 (1 year), 1.4 (2 years): probabilities>0.95 within 6 weeks. EQ-5D was 0.229 preoperatively, 0.563 (6 weeks), 0.687 (3 months), 0.755 (1 year), 0.787 (2 years): probabilities>0.95 within 1 year. Sagittal index was 15.1° preoperatively, 9.6° postoperatively: probability>0.95. Inter-body fusion was: complete 60.7%, partial 17.9%, and nonunion 21.4%. Antibiotic treatment was stopped at 6 weeks in 82.1%, at 3 months in 17.9%, without septic complication.
Conclusion |
Percutaneous instrumentation improved pain control, quality of life and prevented kyphosis. Antibiotic treatment was not influenced. Septic complications were not observed.
Level of evidence |
IV.
Le texte complet de cet article est disponible en PDF.Keywords : Spondylodicitis, Percutaneous instrumentation, Pain, Quality of life
Plan
Vol 105 - N° 6
P. 1165-1170 - octobre 2019 Retour au numéro
Article précédent
- rhBMP-2 (Recombinant Human Bone Morphogenetic Protein-2) in real world spine surgery. A phase IV, National, multicentre, retrospective study collecting data from patient medical files in French spinal centres
- Ange François Vincentelli, Marc Szadkowski, Dominique Vardon, Stéphane Litrico, Stéphane Fuentès, Jean-Paul Steib, Jean-Charles Le Huec, Jean Huppert, Gilles Dubois, Thibaut Lenoir, Frédéric Sailhan, Norbert Passuti
- Correction of thoracic adolescent idiopathic scoliosis via a direct convex rod manoeuvre
- Philippe Violas, Cyril Bryand, Constantin Gomes, Paul Sauleau, Grégory Lucas, the Orthopedics, Traumatology Society of Western France (SOO)
Bienvenue sur EM-consulte, la référence des professionnels de santé.