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Comparative study on the efficacy of two-staged (posterior followed by anterior) surgical treatment using spinal instrumentation on pyogenic and tuberculotic spondylitis.
MedLine Citation:
PMID:  21069364     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Between 1997 and 2006, we treated 11 patients with tuberculotic spondylitis and 19 with pyogenic spondylitis using a two-staged operation (posterior spinal instrumentation, followed by anterior debridement and fusion).
METHOD: We compared changes in inflammatory reactions, postoperative complications, organisms obtained during anterior debridement, neurological status, bone union, and suppression of the infection between the patients with tuberculotic and pyogenic spondylitis.
PATIENTS: All patients in both groups achieved bone union and suppression of the infected sites. Decreases in C-reactive protein and erythrocyte sedimentation rate were significantly slower in the patients with tuberculotic spondylitis. Positive bacterial cultures at the second anterior debridement were obtained from 26% of patients with pyogenic spondylitis and 55% of patients with tuberculotic spondylitis. Frankel types improved in 57% of patients, but there were no differences in neurological improvement. The efficacy of the two-staged operation did not differ between the patients with pyogenic and tuberculotic spondylitis.
RESULTS: Although the baselines were different, there were no significant differences in relative operating parameters, neurological improvement, or postoperative complications between the two groups. At the final follow-up, all patients finally achieved suppression of spinal infection and solid bone fusion in both groups, although the decline in inflammatory parameters was slower in the T group than in the P group.
Authors:
Takahiro Masuda; Kei Miyamoto; Hideo Hosoe; Katsuji Shimizu
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Publication Detail:
Type:  Journal Article     Date:  2010-11-11
Journal Detail:
Title:  Archives of orthopaedic and trauma surgery     Volume:  131     ISSN:  1434-3916     ISO Abbreviation:  Arch Orthop Trauma Surg     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011043     Medline TA:  Arch Orthop Trauma Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  765-72     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan.
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