The long term efficacy of focal cleaning treatment by anterior or anterolateral and the first phase of bone graft and single screw rod fixation surgical intervention treatment of single intervertebral space infection.

Objective To investigate the long term efficacy of focal cleaning treatment by anterior or anterolateral and the first phase of bone graft and single screw rod fixation surgical intervention treatment of single intervertebral space infection. Methods Clinical data of 37 patients (18 males, 19 females) with anterior and anterolateral debridement graft bone fusion and internal fixation in treating single intervertebral space infection in patients in the First Affiliated Hospital of Bengbu Medical College from January 2000 to December 2009 were retrospectively analyzed. Age 19-59 years old, average (49.9±11.0) years old, the body temperature, blood routine and visual analogue scale(VAS) were measured at preoperative and 3 days, 2 weeks, 3 months after operation and the time of the last follow-up. Erythrocyte sedimentation rate(ESR), C reactive protein(CRP) were measured at preoperative and 7 days, 2 weeks, 3 months after operation and the time of the last follow-up. X-ray of abnormal segment of lumbar spine were reviewed to observe the fusion situation of intervertebral bone graft. The curative effect evaluation were made according to the VAS score and X ray 3 months after operation, the time of the last follow-up. Results Surgery was successfully performed in all patients. According to patient history, clinical presentation, imaging findings and the results of bacterial culture, all the patients were in accordance with the infection of intervertebral space. All incisions healed by first intention. All 37 patients were followed up for 66-177 months, with an average of (120.7±30.8) months. For all the patients 3 days, 2 weeks, 3 months after surgery, the end of the follow-up VAS score, and body temperature were lower than those of the preoperative, these differences had statistical significance (all P values<0.05). The white blood cell count of the 3 day after operation was higher than that of the preoperative , all patients of 2 weeks , 3 months after surgery, the end of the follow-up the white blood cell count and the percentage of neutrophil were lower than those of the preoperative, these differences had statistical significance (all P values <0.05). All patients of 1 week, 2 weeks, 3 months after surgery, the end of the follow-up ESR, CRP were lower than those of the preoperative, these differences had statistical significance (all P values<0.05). At 3 months after operation, excellence 25, good 11, tolerableness 1, the excellent and good rate was 97.3%(36/37). Conclusions Focal cleaning treatment by anterior or anterolateral and the first phase of bone graft and single screw rod fixation surgical intervention treatment is a kind of obvious curative effect, economic and practical operation, it should be advocated for the patients who are inefficacious and have severe symptoms. Key words: Lumbar vertebrae; Intervertebral infection; Internal fixation