ID | 110405 |
タイトルヨミ | カノウセイ セキツイエン ニタイスル キョウシカ ツイカンバン ヘルニア テキシュツジュツ PED ノ ジュツゴ セイセキ
|
タイトル別表記 | Clinical outcome of percutaneous endoscopic lumbar surgery for pyogenic spondylitis
|
著者 |
中島, 大生
徳島大学病院卒後臨床研修センター|徳島大学大学院医歯薬学研究部感覚運動系病態医学講座運動機能外科学
寺井, 智也
地方独立行政法人徳島県鳴門病院
林, 二三男
徳島大学大学院医歯薬学研究部感覚運動系病態医学講座運動機能外科学
辺見, 達彦
地方独立行政法人徳島県鳴門病院
|
キーワード | percutaneous endoscopic lumbar discectomy(PED)
local anesthesia
pyogenic spondylitis
|
資料タイプ |
学術雑誌論文
|
抄録 | The number of pyogenic spinal infections has been increasing in the past few decades. The main reason for increasing of cases is increasing of immunosuppressed patients, such as diabetes mellitus, neoplasmic disease, collagen disease or chronic renal failure. Some immunosuppressed patients with pyogenic spinal infection were resistant to an antibiotic treatment and they were not able to undergo major spinal surgery due to their poor general conditions. Percutaneous endoscopic lumbar discectomy(PED)is performed under local anesthesia and requires an8mm skin incision. PED is the least invasive disc surgery procedure, especially for poor general condition patients with pyogenic lumbar spondylitis. The purpose of this study is to evaluate effect of PED procedure for pyogenic spondylitis. Four male and one female pyogenic spondylitis underwent PED surgery under local anesthesia. The mean age was67.0±12.9(47-77). The number of complications for 4 patients is as follows;2malignant tumor,3hypertension,1diabetes mellitus,1liver cirrhosis and 1 Parkinson disease. Causative bacteria were identified in the blood or the biopsy specimens. We performed the debridement of the infected disc and of the partial endplate in the lumbar spine. Approximately3000- 5000milliliter saline was used for irrigation. The mean day from diagnosis to surgery was 12.6 days(11-15 days). Post operative courses of all patients were successful. The mean day to turn CRP negative after surgery is52.2 days(38-110 days). There was no complication and no additional surgery after debridement using PED procedure. The PED procedure is superior to other treatments in terms of directly debridement and lavage the infected sites. The most advantage of PED procedure is able to directly observe on clear vision under endoscope. Moreover, PED surgery can be safely performed under local anesthesia and requires the least invasion. This procedure can be applied to the poor general condition’s patients.
|
掲載誌名 |
四国医学雑誌
|
ISSN | 00373699
|
cat書誌ID | AN00102041
|
出版者 | 徳島医学会
|
巻 | 72
|
号 | 5-6
|
開始ページ | 213
|
終了ページ | 216
|
並び順 | 213
|
発行日 | 2016-12-25
|
フルテキストファイル | |
言語 |
jpn
|
著者版フラグ |
出版社版
|
部局 |
病院
医学系
|