AI Article Synopsis
- The study investigates the effectiveness of a minimally invasive lateral transpsoas approach for treating septic spondylodiscitis, highlighting improvements in patient-reported outcomes and radiographic measures.
- Over the 24-month follow-up, significant enhancements were recorded, with 68% of patients achieving excellent outcomes and 87% achieving complete fusion.
- Despite some graft subsidence seen in patients, it did not negatively impact clinical results, supporting the method as a safe and effective treatment option.
Article Abstract
Background: The minimally invasive lateral transpsoas approach allows retroperitoneal access for discectomy and graft placement. However, the procedure has rarely been used for the treatment of septic spondylodiscitis. The purposes of this study were to evaluate the clinical and radiographic outcomes from this minimally invasive procedure for septic spondylodiscitis.
Methods: Thirty-one consecutive patients (17 males and 14 females) were included in this study from July 2013 to January 2016. Clinical outcomes were assessed by Oswestry Disability Index, visual analog scale, modified Macnab criteria, and inflammatory parameters. Radiographic results were analyzed by studying the changes in diseased disc height, lordosis, and fusion status.
Results: The Oswestry Disability Index and visual analog scale score improved by 58% and 69% at the last follow-up. The modified Macnab criteria were found to be excellent in 21 patients (68%) and good in 10 (32%). Inflammatory parameters normalized over the average 24 months follow-up. There were no major complications that might have influenced the outcomes in this cohort. A complete fusion after 12 months was achieved in 87% of patients. A mean 7.5 mm restoration in disc height and 6.4° restoration in lumbar lordosis were observed in all patients, whereas an average 4.5 mm loss in restored height resulting from graft subsidence was observed in 24 patients during the follow-up. However, graft subsidence did not influence clinical outcomes significantly.
Conclusions: A minimally invasive lateral transpsoas approach in combination with instrumentation provides a novel treatment for patients with septic spondylodiscitis without severe kyphosis and neurologic impairment.
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| http://dx.doi.org/10.1016/j.wneu.2018.03.193 | DOI Listing |
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