Efficacy of percutaneous transforaminal endoscopic debridement on early lumbar brucellar spondylitis

ZHAO Chang-song; ZHANG Qiang; ZHAO Ru-gang; ZHANG Yao; LI Xin; SUN Sheng

doi:10.3969/j.issn.1007-8134.2018.01.012

Abstract：Objective To evaluate the efficacy of percutaneous transforaminal endoscopic debridement in treatment of early lumbar brucellar spondylitis. Methods A retrospective analysis on follow-up patients of early lumbar brucellar spondylitis treated with percutaneous transforaminal endoscopic debridement from January 2011 to May 2017 in Beijing Ditan Hospital was performed. The involved patients were detected at three stages, namely before operation, first day after operation and at the last follow-up. Clinical efficacy in patients with early lumbar brucellar spondylitis was evaluated by visual analogue scale (VAS) and Oswestry disability index (ODI) with statistical method. Results A total of 13 patients were enrolled in the study. Doxycycline, rifampicin, third-generation cephalosporins and levofloxacin mesylate injection as the combined therapy on brucellosis were used in a regular and full course before and after operation. All the operations were performed by percutaneous transforaminal endoscopic debridement. All patients underwent surgery successfully. The average postoperative follow-up time was 8.9 months. After operation, VAS and ODI were lower than before operation (P<0.05), Back pain were significantly relieved and the ability of independent living was gradually improved after operation. During follow-ups, all the incisions healed at stage 1 after operation without local sinus formation and there were no spinal cord, cauda equina, nerve root or vascular injuries. No patients underwent debridement, fusion and internal fixation during follow-ups. Conclusions On the basis of drug therapy, percutaneous transforaminal endoscopic debridement is safe and effective in treatment of early lumbar brucellar spondylitis, which can relieve back pain as soon as possible and improve the quality of life.