One stage posterior debridement and fusion for severe lumbar discitis

English Keywords:Discitis  Debridement  Allograft bone grafts  Intervertebral fusion  Internal fixation

English Abstract:

  【Abstract】 Objectives: To evaluate the efficacy of one stage posterior debridement and fusion for severe lumbar discitis. Methods: From December 2005 to December 2010, 11 cases suffering from severe lumbar discitis and no responsive to conventional treatment experienced one stage posterior debridement, allograft bony graft and fusion. VAS score was used to evaluate clinical outcome of preoperation and 1, 7, 14 days and final follow-up after operation. Erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) were used to assess the pre and postoperative general condition. X-ray was used to evaluate the stability and bone fusion. Results: All the patients had low back pain relieved significantly after operation and were capable of turning around. The VAS for low back pain was 8.25±2.21, 4.36±2.43, 2.59±2.13, 2.38±1.13 and 1.88±1.21 for preoperation, 1, 7, 14 day and final follow-up respectively, which showed significant difference between preoperation and postoperation counterparts(P<0.05).　Four patients had ESR increased 3 days after operation, then decreased gradually. All patients had CRP decreased significantly after surgery, and had ESR and CRP returning to normal(ESR<15mm/h, CRP<8mg/L) 2 to 4 weeks later.　No skin incision infection was noted. All patients were followed up for 6-24 months(average 13 months), and all patients got bony fusion 6-12 months later. Conclusions: One stage posterior debridement and fusion is anti-inflammatory and can reach pain-relief quickly as well as stability reconstruction, which is effective for severe discitis.