요추 추간판 절제술 후 발생한 화농성 척추염에 대한 Chuinard ＆ Peterson 골 이식술을 이용한 전방 유합술 및 경피적 후관절 나사못 고정술 = Anterior Lmbar Interbody Fusion with Chuinard ＆ Peterson Bone Graft and Posterior Percutaneous Facet Screw Fixation for Post-discectomy Pyogenic Spondylitis

다국어 초록 (Multilingual Abstract)

Objective: To describe the surgical techniques and the preliminary results of anterior fusion with Chuinard ＆ Peterson bone graft and posterior percutaneous facet screw fixation for pyogenic spondylitis following lumbar discectomy.
Methods: From April to October 2003, five consecutive patients underwent anterior lumbar interbody fusion with Chuinard ＆ Peterson bone graft and posterior percutaneous facet screw fixation for the treatment of pyogenic spondylitis that developed after primary lumbar disc surgery. There were three males and two females. The mean age was 49.8 years(range, 28-75 years). Three patients had persistent inflammation with neurologic deterioration and two had severe back pain despite of less invasive interventions. The mean interval from the primary operation to fusion was 3.3 months(range, 1.5~7 months). All patients were allowed to ambulate immediate postoperatively with a lumbar orthosis, which was kept for three months. Intravenous and oral antibiotics were continued until hematologic profiles normalized. All patients were followed up clinically and radiologically.
Results: The mean operating time, blood loss, and post-operative hospital stay were 210 mins, 890 ml, and 27 days, respectively. Four patients showed a solid fusion at 3 monthes and one patient showed fusion at 4 monthes postoperatively. M patients showed remission of infection and significant clinical improvement of back pain.
Conclusions: Anterior fusion using Chuinard ＆ Peterson bone graft and posterior facet screw fixation may be employed for postoperative pyogenic spondylitis without prolonged cast immobilization or risk of persistent infection caused by instrumentation.