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Orthop Traumatol Surg Res ; 105(6): 1165-1170, 2019 10.
Article in English | MEDLINE | ID: mdl-31471258

ABSTRACT

BACKGROUND: Patients with spondylodiscitis are treated with antibiotics and braces for 6 to 12 weeks. Braces aim to decrease pain and prevent kyphotic deformity due to vertebral body collapse. Percutaneous instrumentation could be an alternative to influence pain and patient's autonomy. PURPOSE: The purpose of this study was to analyze back pain, quality of life, sagittal deformity, and complications after percutaneous instrumentation in spondylodiscitis. PATIENTS AND METHODS: VAS for back pain, EQ-5D, radiographic sagittal index were assessed retrospectively for 28 patients who had a standardized follow-up at 5 days, 6 weeks, 3 months, 1 and 2 years. Probabilities>0.95 indicated significant changes (Bayesian model). RESULTS: VAS was 7.0 preoperatively, 3.2 (day 5), 2.2 (6 weeks), 1.9 (3 months), 1.6 (1 year), 1.4 (2 years): probabilities>0.95 within 6 weeks. EQ-5D was 0.229 preoperatively, 0.563 (6 weeks), 0.687 (3 months), 0.755 (1 year), 0.787 (2 years): probabilities>0.95 within 1 year. Sagittal index was 15.1° preoperatively, 9.6° postoperatively: probability>0.95. Inter-body fusion was: complete 60.7%, partial 17.9%, and nonunion 21.4%. Antibiotic treatment was stopped at 6 weeks in 82.1%, at 3 months in 17.9%, without septic complication. CONCLUSION: Percutaneous instrumentation improved pain control, quality of life and prevented kyphosis. Antibiotic treatment was not influenced. Septic complications were not observed. LEVEL OF EVIDENCE: IV.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Back Pain/therapy , Braces , Discitis/therapy , Lumbar Vertebrae/surgery , Spinal Fusion/instrumentation , Thoracic Vertebrae/surgery , Adult , Aged , Aged, 80 and over , Back Pain/diagnosis , Back Pain/etiology , Discitis/complications , Discitis/diagnosis , Female , Humans , Lumbar Vertebrae/diagnostic imaging , Magnetic Resonance Imaging , Male , Middle Aged , Retrospective Studies , Thoracic Vertebrae/diagnostic imaging , Tomography, X-Ray Computed , Treatment Outcome
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