nach oben

European Spine Journal

Erschienen in:

01.05.2012 | Original Article

The anterior stand-alone approach (ASAA) during the acute phase of spondylodiscitis: results in 40 consecutively treated patients

verfasst von: Giuseppe D’Aliberti, Giuseppe Talamonti, Fabio Villa, Alberto Debernardi

Erschienen in: European Spine Journal | Sonderheft 1/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Spondylodiscitis mainly affects the anterior part of the spine. In this paper, we retrospectively analyze our experience with the anterior stand-alone approach (ASAA) in the treatment of spinal infections.

Methods

Forty consecutive patients with severe spondylodiscitis underwent the ASAA during the acute infective phase. Treatment consisted of disease debridement, vertebral body reconstruction using titanium expandable prostheses and anterior fixation.

Results

There was neither mortality nor major morbidity. Successful arthrodesis was achieved in 39 out of 40 patients who remained disease free throughout the follow-up period. Six months after treatment, one patient experienced pseudarthrosis and required supplemented posterior spinal fixation for vertebral instability. However, adequate arthrodesis was eventually obtained even in this patient.

Conclusions

ASAA with spine reconstruction using synthetic materials during the acute infection phase was safe and effective. The infections were rapidly defeated, the patients were allowed to stand up early after the procedure and the length of hospital stay was significantly reduced.

Hodgson AR, Stock FE, Fang HS, Ong GB (1960) Anterior spinal fusion. The operative approach and pathological findings in 412 patients with Pott’s disease of the spine. Br J Surg 48:172–178PubMedCrossRef

Krodel A, Sturz H (1989) Differentiated surgical and conservative treatment of spondylitis and spondylodiscitis. Z Orthop Ihre Grenzbeg 127:587–596 in GermanCrossRef

Eismont FJ, Bohlman HH, Soni PL, Goldberg VM, Freehafer AA (1983) Pyogenic and fungal vertebral osteomyelitis with paralysis. J Bone Joint Surg Am 65:19–29PubMed

Calderone RR, Larsen JM (1996) Overview and classification of spinal infections. Orthop Clin North Am 27:1–8PubMed

D’Aliberti G, Talamonti G, Villa F, Debernardi A, Sansalone CV, LaMaida A, Torre M, Collice M (2008) Anterior approach to thoracic and lumbar spine lesions: results in 145 consecutive cases. J Neurosurg Spine 9:466–482PubMedCrossRef

Chang CC, Merritt K (1994) Infection at the site of implanted materials with and without preadhered bacteria. J Orthop Res 12:526–531PubMedCrossRef

American Spinal Cord Injury Association (1992) Standards for neurological and functional classification of spinal cord injury, revised. Americal Spinal Cord Injury Association, Chicago

Denis F, Armstrong GW, Searls K, Matta L (1984) Acute thoracolumbar burst fractures in the absence of neurologic deficit. A comparison between operative and nonoperative treatment. Clin Orthop Relat Res 189:142–149PubMed

Kim KD, Johnson PJ, Masciopinto JE (1999) Management of spinal epidural abscess and subdural empyema. Tech Neurosurg 5:293–302CrossRef

10.

McHenry MC, Easley KA, Locker GA (2002) Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Cleveland-area hospitals. Clin Infect Dis 34:1342–1350PubMedCrossRef

11.

Hsieh P, Wienecke RJ, O’Shaughnessy BA, Koski TR, Ondra SL (2004) Surgical strategies for vertebral osteomyelitis and epidural abscess. Neurosurg Focus 17:E4PubMedCrossRef

12.

Turgut M (2001) Spinal tuberculosis (Pott’s disease): its clinical presentation, surgical management, and outcome. A survey study on 694 patients. Neurosurg Rev 24:8–13PubMedCrossRef

13.

Ruf M, Strolze D, Merck RH, Ames M, Harms J (2007) Treatment of vertebral osteomyelitis by radical debridement and stabilization using titanium mesh cage. Spine 32:E275–E280PubMedCrossRef

14.

Kuklo TR, Potter BK, Bell SB, Moquin RR, Rosner MK (2006) Single-stage treatment of pyogenic spinal infection with titanium mesh cages. J Spinal Disord Tech 19:376–382PubMedCrossRef

15.

Sundararaj GD, Behera S, Ravi V, Venkatesh K, Cherian VM, Lee V (2003) Role of posterior stabilization in the management of tuberculosis of the dorsal and lumbar spine. J Bone Joint Surg Br 85:100–106PubMedCrossRef

16.

Yilmaz C, Selek HY, Gurkan I, Erdemli B, Korkusuz Z (1999) Anterior instrumentation for the treatment of spinal tuberculosis. J Bone Joint Surg Am 81:1261–1267PubMed

17.

Dvorak MF, Known BK, Fisher CG, Eiserloh HL, Boyd M, Wing PC (2003) Effectiveness of titanium mesh cylindrical cages in anterior column reconstruction after thoracic and lumbar vertebral body resection. Spine 28:902–908PubMed

18.

Grob D, Daehn S, Mannion AF (2005) Titanium mesh cages (TMC) in spine surgery. Eur Spine J 14:211–221PubMedCrossRef

19.

Ecklund JM, Depper MH, Zeidman SM (1999) Pyogenic vertebral osteomyelitis. Tech Neurosurg 5:282–292CrossRef

20.

Moon MS, Woo YK, Lee KS, Ha KY, Kim SS, Sun DH (1995) Posterior instrumentation and anterior interbody fusion for tuberculous kyphosis of dorsal and lumbar spines. Spine 20:1910–1916PubMedCrossRef

21.

Emery SE, Chan DP, Woodward HR (1989) Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting. Spine 14:284–291PubMed

22.

Krodel A, Kruger A, Lohscheidt K, Pfahler M, Reflor HJ (1999) Anterior debridement, fusion, and extrafocal stabilization in the treatment of osteomyelitis of the spine. J Spinal Disord 12:17–26PubMed

23.

Klockner C, Valencia R (2003) Sagittal alignment after anterior debridement and fusion with or without additional posterior instrumentation in the treatment of pyogenic and tuberculous spondylodiscitis. Spine 28:1036–1042PubMed

24.

Safran O, Rand N, Kaplan L, Sagiv S, Floman Y (1998) Sequential or simultaneous, same-day anterior decompression and posterior stabilization in the management of vertebral osteomyelitis of the lumbar spine. Spine 23:1885–1890PubMedCrossRef

25.

McDonnel DE, Harrison SJ (1998) Lateral approach to the craniocervical complex. Tech Neurosurg 4:306–318

Titel: The anterior stand-alone approach (ASAA) during the acute phase of spondylodiscitis: results in 40 consecutively treated patients
verfasst von: Giuseppe D’Aliberti
Giuseppe Talamonti
Fabio Villa
Alberto Debernardi
Publikationsdatum: 01.05.2012
Verlag: Springer-Verlag
Erschienen in: European Spine Journal / Ausgabe Sonderheft 1/2012
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2238-7

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Sonderheft 1/2012

Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis

Sagittal profile control in patients affected by neurological scoliosis using Universal Clamps: a 4-year follow-up study

Neurological L5 burst fracture: posterior decompression and lordotic fixation as treatment of choice

Spine surgery in Italy between neuro and ortho surgeons

Lumbar spinal stenosis treatment with aperius perclid interspinous system

Prospective study of a new dynamic stabilisation system in the treatment of degenerative discopathy and instability of the lumbar spine