Implantation of calcium sulfate powder and antibiotics for the treatment of suppurative spondyfitis of the thoracic vertebra

Jinsong WEI; Rong ZENG; Hao LIN; Zibing HU

ABSTRACT

BACKGROUND:

Treatment prescription for intervertebral space infection is controversial. Conventionally,lying in bed,physical therapy,symptomatic therapy,and a large dosage of antibiotics were used frequently;however,the application of antibiotics was still controversial.

OBJECTIVE:

To explore the implantation of calcium sulfate powder combined with antibiotics for the treatment of suppurative spondyfitis of the thoracic vertebra. DESIGN,TIME AND

SETTING:

A retrospective case analysis was performed at Department of Orthopaedics,Affiliated Hospital of Guangdong Medical College from October 2000 to August 2008.

PARTICIPANTS:

A total of 24 patients with suppurative spondyfitis of the thoracic vertebra,including 9 males and 15 females and aging 42-71 years,were provided by Department of Orthopaedics,Affiliated Hospital of Guangdong Medical College. Suppurative spondyfitis of thoracic vertebra occurred on T6/7(n=9) ,T7/8(n=6) ,T8/9(n=3) ,T10/11(n=4) ,and T6/8(n=2) . Among all patients,8 cases had severe pain,myospasm of dorsal muscles,passive position,difficulty of turning over,and lateral or bilateral melosalgia;11 had anorexia and athrepsy;2 had paresis of both lower extremities and difficulty of automatic micturition;3 had diabetes mellitus.

METHODS:

After the 24 patients with suppurative spondyfitis of the thoracic vertebra received the cleaning operation on focus infection through latero-anterior thoracic cavity,the defect area of bone was inserted with titanium case filled with the calcium sulfate cement combined with antibiotics,and then the internal fixation and a plenty of antibiotics were applied after the operation. MAIN OUTCOME

MEASURES:

Recovery rate was evaluated using JOA assay,and blood sedimentation and bone healing were observed.

RESULTS:

All the 24 patients received the follow-up with the mean duration of 5.8 years. One case did not recovered,but other 23 patients recovered obviously. The recovery rate was 30%-100%. Blood sedimentation decreased from(86.74?10.56) mm/h before operation to(26.40?5.42) mm/h at 5 months after operation. Bone fusion occurred on all 24 patients,and the time lasted for 3-8 months. Relative death,complications,and infection-induced relapse were not found during the following up.

CONCLUSION:

To insert the titanium case filled with the calcium sulfate cement combined with antibiotics into the defect area of bone created by the cleaning operation on focus infection and combine with the application of the internal fixation by one stick and two screw and the brace for back and lumbar is an effective therapy for treatment of suppurative spondyfitis of the thoracic vertebra.