Transpedicular fixation for hematogenous pyogenic vertebral osteomyelitis
Objective. To analyze the effectiveness of conservative treatment and extrafocal transpedicular fixation in patients with uncomplicated hematogenous pyogenic vertebral osteomyelitis (PVO). Material and Methods. Ninety seven medical records of in-patients who were treated for hematogenous PVO in 2...
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| Format: | Article |
| Language: | English |
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Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
2020-06-01
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| Series: | Хирургия позвоночника |
| Subjects: | |
| Online Access: | https://www.spinesurgery.ru/jour/article/view/1694/1679 |
| _version_ | 1797721977587236864 |
|---|---|
| author | Aleksandr Yu. Bazarov |
| author_facet | Aleksandr Yu. Bazarov |
| author_sort | Aleksandr Yu. Bazarov |
| collection | DOAJ |
| description | Objective. To analyze the effectiveness of conservative treatment and extrafocal transpedicular fixation in patients with uncomplicated
hematogenous pyogenic vertebral osteomyelitis (PVO).
Material and Methods. Ninety seven medical records of in-patients who were treated for hematogenous PVO in 2007–2017 were analyzed.
Among them, men accounted for 73.2 % (n = 71) and women – 26.8 % (n = 26). The acute and subacute forms of the disease were diagnosed
in 62 (63.9 %) patients and chronic – in 35 (36.1 %). Type A according to Pola classification totaled 45 patients, type B – 49 and type C – 3.
Sixty four (66.0 %) patients were treated conservatively, 33 (34.0 %) – using transpedicular fixation and 25 (75.8 %) – using minimally invasive technique. No fixators were placed in the affected vertebrae. All patients underwent antibacterial therapy lasting 6–12 weeks.
Results. Good treatment results were obtained in 89 (91.8 %) patients. There were no differences in the severity of pain between the comparison groups before the start of treatment and after one year. However, the pain severity was significantly reduced (p = 0.001) over the time of treatment. Positive results of transpedicular fixation were obtained in 28 (84.8 %) cases, and after three repeated interventions – in 32 (94.1 %), and those of conservative treatment – in 61 (95.3 %) cases. The total number of relapses was 8 (8.2 %), of complications – 3 (3.1 %). The risk of relapse among operated drug addicts was significantly higher (p = 0.033). There were no deaths in the comparison
groups, which is explained by the study inclusion and exclusion criteria. All discharged patients were followed-up on an outpatient basis
for at least a year, and 72.2 % of them – from 1 year to 8 years.
Conclusion. Transpedicular fixation is indicated for uncomplicated hematogenous pyogenic vertebral osteomyelitis, monosegmental lesions and in cases of demands on improved quality of life. The use of such a technique in drug addicts is not recommended. |
| first_indexed | 2024-03-12T09:41:07Z |
| format | Article |
| id | doaj.art-43fda28dc5b6400c85cd12b066f0958c |
| institution | Directory Open Access Journal |
| issn | 1810-8997 2313-1497 |
| language | English |
| last_indexed | 2024-03-12T09:41:07Z |
| publishDate | 2020-06-01 |
| publisher | Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" |
| record_format | Article |
| series | Хирургия позвоночника |
| spelling | doaj.art-43fda28dc5b6400c85cd12b066f0958c2023-09-02T13:13:11ZengMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"Хирургия позвоночника1810-89972313-14972020-06-01172737810.14531/ss2020.2.73-78Transpedicular fixation for hematogenous pyogenic vertebral osteomyelitisAleksandr Yu. Bazarov0https://orcid.org/0000-0002-5309-4667Regional Clinical Hospital No. 2, Tyumen, RussiaObjective. To analyze the effectiveness of conservative treatment and extrafocal transpedicular fixation in patients with uncomplicated hematogenous pyogenic vertebral osteomyelitis (PVO). Material and Methods. Ninety seven medical records of in-patients who were treated for hematogenous PVO in 2007–2017 were analyzed. Among them, men accounted for 73.2 % (n = 71) and women – 26.8 % (n = 26). The acute and subacute forms of the disease were diagnosed in 62 (63.9 %) patients and chronic – in 35 (36.1 %). Type A according to Pola classification totaled 45 patients, type B – 49 and type C – 3. Sixty four (66.0 %) patients were treated conservatively, 33 (34.0 %) – using transpedicular fixation and 25 (75.8 %) – using minimally invasive technique. No fixators were placed in the affected vertebrae. All patients underwent antibacterial therapy lasting 6–12 weeks. Results. Good treatment results were obtained in 89 (91.8 %) patients. There were no differences in the severity of pain between the comparison groups before the start of treatment and after one year. However, the pain severity was significantly reduced (p = 0.001) over the time of treatment. Positive results of transpedicular fixation were obtained in 28 (84.8 %) cases, and after three repeated interventions – in 32 (94.1 %), and those of conservative treatment – in 61 (95.3 %) cases. The total number of relapses was 8 (8.2 %), of complications – 3 (3.1 %). The risk of relapse among operated drug addicts was significantly higher (p = 0.033). There were no deaths in the comparison groups, which is explained by the study inclusion and exclusion criteria. All discharged patients were followed-up on an outpatient basis for at least a year, and 72.2 % of them – from 1 year to 8 years. Conclusion. Transpedicular fixation is indicated for uncomplicated hematogenous pyogenic vertebral osteomyelitis, monosegmental lesions and in cases of demands on improved quality of life. The use of such a technique in drug addicts is not recommended.https://www.spinesurgery.ru/jour/article/view/1694/1679pyogenic vertebral osteomyelitisspondylitisspondylodiscitistranspedicular fixationconservative treatment |
| spellingShingle | Aleksandr Yu. Bazarov Transpedicular fixation for hematogenous pyogenic vertebral osteomyelitis Хирургия позвоночника pyogenic vertebral osteomyelitis spondylitis spondylodiscitis transpedicular fixation conservative treatment |
| title | Transpedicular fixation for hematogenous pyogenic vertebral osteomyelitis |
| title_full | Transpedicular fixation for hematogenous pyogenic vertebral osteomyelitis |
| title_fullStr | Transpedicular fixation for hematogenous pyogenic vertebral osteomyelitis |
| title_full_unstemmed | Transpedicular fixation for hematogenous pyogenic vertebral osteomyelitis |
| title_short | Transpedicular fixation for hematogenous pyogenic vertebral osteomyelitis |
| title_sort | transpedicular fixation for hematogenous pyogenic vertebral osteomyelitis |
| topic | pyogenic vertebral osteomyelitis spondylitis spondylodiscitis transpedicular fixation conservative treatment |
| url | https://www.spinesurgery.ru/jour/article/view/1694/1679 |
| work_keys_str_mv | AT aleksandryubazarov transpedicularfixationforhematogenouspyogenicvertebralosteomyelitis |