Article
Modern strategies in treatment of thorakolumbal spondylodiscitis
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Published: | June 13, 2005 |
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Outline
Text
Study design
Retrospective clinical and laboratory data analyses were performed on patients with thorakolumbal spondylodiscitis (TS).
Objectives
Patients with TS often present with non specific symptoms leading to a late diagnosis. Therefore fast and precise diagnosing and treatment is crucial to prevent lethal outcomes. Our group has retrospectively revaluated 13 patients with TS treated at our clinic working out differences in today's major treatment strategies concerning outcome.
Methods
From 02-17-2003 till 04-03-2004 13 patients (4 females and 9 males) were treated. The average age was 59 (20-81) years. Three different strategies were preformed. Group 1: Five patients were treated with dorsal stabilisations, additionally they received either transpedicular relief or laminektomia. Group 2: Six patients treated with isolated ventral stabilisation using endoscopic assisted and computer navigated instruments. Group 3: Three patients treated with a combined dorsoventral procedure. All Patients received an antibiotic treatment for about 8 (2 -12) weeks without significant clinical effects. More sever cases of TS were found in group 2 and 3, where the diagnosis was accompanied by empyema of the pleura (n=3), abscesses (n=2) complications after dorsal stabilisation (n=2).
Results
Although all patients were in critical preoperational condition radical surgery was always beneficial to them. Comparing the groups, group 2 has shown a lower CRP elevation after surgery. All preoperational neurological deficits were ascending and disappearing. In contrast to group 1 healing rate in group 2 and 3 was 100% over 80 % in group1.
Conclusions
The ventral approach had the best outcomes concerning the investigated parameters.