Observation on the curative effect of surgical treatment of suppurative spondylitis after percutaneous vertebroplasty

English Keywords:Suppurative spondylitis  Percutaneous vertebroplasty  Surgical treatment

English Abstract:

  【Abstract】 Objectives: To observe the clinical effect of surgical treatment of suppurative spondylitis after percutaneous vertebroplasty(PVP). Methods: The medical records of 14 patients with suppurative spondylitis after PVP treatment admitted to the Department of Orthopedics of our hospital from March 2017 to February 2022 were retrospectively analyzed. There were 6 males and 8 females, aged 53-83 years, with an average age of 69.3±7.8 years. The patients were followed up for 12 months. The operation time, intraoperative blood loss, postoperative complications, postoperative recurrence rate, postoperative visual analogue scale(VAS) and American Spinal Injury Association(ASIA) improvement, postoperative bone graft fusion rate, and postoperative quality of life(short form-36, SF-36) improvement were analyzed to observe the clinical effect and related risks of surgical treatment of suppurative spondylitis after PVP treatement. Results: The operative time of 14 patients was 123-300min, with an average of 205.1±57.4min. Intraoperative blood loss was 200-900mL, with an average of 517.9±181.5mL. Postoperative incision complications occurred in 2 patients(14.3%), of which, 1 case was incision effusion, healed after drainage and dressing change; The other case was delayed healing, which healed after regular dressing change, improving nutritional status and blood sugar control. The VAS scores ranged from 3 to 8 points(6.1±1.6 points) before operation, which was 0-2 points(0.9±0.8 points) at final follow-up, and the difference was statistically significant(t=11.034, P=0.000). The bone graft fusion rate was 92.8%(13/14), and the fusion time was 3 to 7 months(4.6±1.3 months). Spinal infection recurred at 7 months after surgery in the 1 patient with unfused bone graft, who presented internal fixation loosening and kyphotic deformity and was cured after anti-infection, control of complications, and reoperation. According to the ASIA classification, 2 patients were grade D and 12 patients were grade E before surgery, which all improved to grade E at final follow-up. At final follow-up, the SF-36 scores of the patients were significantly improved compared with those before surgery, and the comprehensive measurement score of physiological health was 31.4±6.9 before surgery and 79.8±6.0 after surgery, and the difference was with statistical significance(t=19.721, P=0.000). The comprehensive measurement score of mental health was 46.9±7.2 before surgery and 88.5±6.4 after surgery, and the difference was statistically significant(t=16.027, P=0.000). Conclusions: Surgery can effectively treat suppurative spondylitis after PVP treatment and improve the quality of life of patients.