LATEST ADVANCES IN MINIMALLY INVASIVE SPINE SURGERY FOR TREATMENT OF INFECTIOUS SPONDYLITIS

Author:

Chao Hsien1,Tsai Tsung-Ting23ORCID,Yeh Yu-Cheng2,Chiu Ping-Yeh2,Kao Fu-Cheng2,Hsieh Ming-Kei2,Lai Po-Liang2,Fu Tsai-Sheng2,Niu Chi-Chien2

Affiliation:

1. Department of Medical Education, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC

2. Department of Orthopaedic Surgery, Spine Section and Bone and Joint Research, Center Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC

3. School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC

Abstract

Nowadays, minimal invasive surgery (MIS) plays an important role in the treatment of infectious spondylitis. This paper reviews the current options in MIS techniques and discusses the surgical outcomes from a series of cases at our department. Demographic characteristics and pre-operative clinical status of 21 patients with MIS for multilevel infectious spondylitis were analyzed; also, pre- and post-operative X-rays were assessed for surgical correction angles and fusion status. The results indicated that percutaneous endoscopic debridement (PEDD) and drainage has the advantages of less blood loss and shorter recovery time. Overall, percutaneous screw system can preserve paravertebral soft tissue, reduce post-operative pain, and foster early post-operative mobilization. Robot-assisted percutaneous screw placement is more accurate than using free-hand. Cortical bone trajectory (CBT) screw requires less surgical exposure while preserving adequate strength. Endoscopic lumbar interbody fusion (Endo-LIF) is an alternative fusion technique to treat spondylitis because it offers better functional prognosis than minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of degenerative lumbar diseases. All the enrolled patients via MIS-TLIF obtained good surgical outcomes. Various minimally invasive techniques have been evolved and modified, so it is important for spine surgeon to keep up to date with advanced orthopedic knowledge and surgical techniques.

Funder

Ministry of Science and Technology, Taiwan

Publisher

World Scientific Pub Co Pte Ltd

Subject

Orthopedics and Sports Medicine

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