Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (13): 2063-2068.doi: 10.3969/j.issn.2095-4344.2015.13.018

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Primary lumbar intervertebral infection: debridement, bone graft and pedicle screw placement fixation 

Li Long, Sheng Wei-bin, Yang Sen, Guo Hai-long   

  1. Department of Spine Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Received:2015-01-16 Online:2015-03-26 Published:2015-03-26
  • Contact: Guo Hai-long, Associate professor, Chief physician, Master’s supervisor, Department of Spine Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • About author:Li Long, Studying for master’s degree, Department of Spine Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China

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Abstract:

BACKGROUND: The method in repair of primary lumbar intervertebral infection is different in different positions, mainly containing anterior, posterior and anteroposterior pathways. In posterior pathway, muscle gap approach is recognized by many fellows. This program has its special advantage compared with conventional posteromedial approach. 
OBJECTIVE: To evaluate the clinical effects of debridement, bone graft and internal fixation of pedicle screw placement in repair of primary lumbar intervertebral infection through posterior paraspinal muscle approach.
METHODS: Clinical data of 13 patients with primary lumbar intervertebral infection were analyzed retrospectively. There were one case of L2-L3, two cases of L3-L4, four cases of L4-L5 and six cases of L5-S1. Lumbar pain was 
obvious in all patients. Nine cases suffered from radioactive lower limb pain. All patients received debridement, bone graft and internal fixation of pedicle screw placement through paraspinal muscle approach via posteromedial incision. After treatment, clinical effects were evaluated using Visual Analog Scale and lumbar Japanese Orthopaedic Association scores.
RESULTS AND CONCLUSION: All patients were followed up for 12-18 months, no recurrence. X-ray review demonstrated bony fusion, so loosening and breakage were not found in all patients. Visual Analog Scale scores revealed that Visual Analog Scale score was 8.15 preoperatively, 2.15 at 1 week postoperatively, 1 at final follow-up, showing significant difference (P < 0.05). There was significant difference in pain between pre-treatment and post-treatment, and pain apparently relieved after treatment. Lumbar Japanese Orthopaedic Association score showed that effective outcomes were found in all patients after treatment, including nine cases of excellent effects, three cases of good effects, one case of average effects, with the excellent and good rate of 92%. Above findings confirmed that one-stage debridement, bone graft and internal fixation of pedicle screw placement through posterior muscle gap approach provides a good repair method for patients with primary lumbar intervertebral infection. It can achieve intervertebral space directly through intervertebral foramen, retain the central spinous process and lamina, reduce the injury to paraspinal muscle, and keep spinal ligament complex. However, strong spine fixation contributes to bone fusion, and keeps the stability of the spine after repair.


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


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Key words: Lumbar Vertebrae, Infection, Internal Fixators

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