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| ZHANG Yongyuan,SUN Honghui,JIANG Chao.One-stage anterior debridement combined with posterior second sacral alar-iliac screw fixation for lumbosacral nonspecific infection[J].Chinese Journal of Spine and Spinal Cord,2021,(2):145-151. |
| One-stage anterior debridement combined with posterior second sacral alar-iliac screw fixation for lumbosacral nonspecific infection |
| Received:June 12, 2020 Revised:September 07, 2020 |
| English Keywords:Lumbosacral infection S2AI screw Internal fixation Surgical treatment |
| Fund:国家自然科学基金重点项目（编号：81830077） |
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| English Abstract: |
| 【Abstract】 Objectives: To investigate the effect of one-stage anterior debridement combined with posterior second sacral alar-iliac(S2AI) screw fixation for lumbosacral nonspecific infection. Methods: The patients with lumbosacral infection who had undergone one-stage anterior debridement combined with posterior S2AI screw fixation from January 2016 to January 2018 were retrospectively analyzed. A total of 10 cases were enrolled in this study, consisting of 7 males and 3 females, with an average age of 61.8±7.7 years． All patients were spontaneously infected, of whom, 3 were complicated with diabetes mellitus. All patients were excluded from tuberculosis and Brucella infection. Leukocyte count, erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were collected in all patients before operation. Antibiotics were administered according to the results of bacterial culture and susceptibility test before operation. The administration of sensitive antibiotics was continued after operation. Leukocyte count, ESR and CRP were monitored to guide the use of antibiotics. The operation time, intraoperative blood loss, preoperative visual analogue scale(VAS), preoperative lumbar Japanese Orthopedic Association(JOA) score, final follow-up VAS score and JOA score were recorded. The results of internal fixation and bone graft fusion were observed. Results: All patients underwent the operation successfully. The operation time ranged from 165 to 225 minutes, with an average of 193.5±20.6 minutes. The intraoperative blood loss was 200-450ml, with an average of 310.0±81.0ml. The incision healed in one stage. The antibiotic use time was 83-97 days, with an average of 89.2±4.5 days. Leukocyte count, ESR and CRP decreased to normal levels 3 months after operation. No relapse of infection was found during follow-up. The average VAS score of low back pain decreased from 6.4±1.0 before operation to 1.4±1.0 at final follow-up(P<0.05), and the JOA score increased from 14.4±2.8 pre-operation to 24.3±2.9 at final follow-up(P<0.05). At final follow-up, bone graft fusion was good in all cases. Conclusions: One-stage anterior debridement combined with posterior S2AI screw fixation for lumbosacral infection can achieve rigid fixation and satisfactory results. |
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