Percutaneous Endoscopic Interbody Debridement and Fusion (PEIDF) Decreases Risk of Sepsis and Mortality in Treating Infectious Spondylodiscitis for Patients with Poor Physical Status, a Retrospective Cohort Study

Background: Postoperative immunosuppression is associated with blood loss and surgical trauma during surgery and subsequently predisposes patients to increased morbidity. Spine endoscopic surgery has been accepted as an effective surgical technique with less surgical trauma and less blood loss for t...

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Published in:Biomedicines 2022-07, Vol.10 (7), p.1659
Main Authors: Wang, Sheng-Fen, Tsai, Tsung-Ting, Li, Yun-Da, Chiu, Ping-Yeh, Hsieh, Ming-Kai, Liao, Jen-Chung, Lai, Po-Liang, Kao, Fu-Cheng
Format: Article
Language:English
Subjects:
Antibiotics
Back pain
Back surgery
Blood
Blood transfusion
Bone surgery
Cardiopulmonary resuscitation
Cohort analysis
CPR
Debridement
Endoscopy
Epidural
Gender
Hemoglobin
Hemorrhage
Immunosuppression
infectious spondylodiscitis
Intensive care
Laboratories
Morbidity
Mortality
Orthopedics
Patients
qSOFA
Sepsis
Spine (lumbar)
Spondylodiscitis
Statistical analysis
Surgical techniques
Trauma
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Summary:Background: Postoperative immunosuppression is associated with blood loss and surgical trauma during surgery and subsequently predisposes patients to increased morbidity. Spine endoscopic surgery has been accepted as an effective surgical technique with less surgical trauma and less blood loss for the complication of infectious spondylodiscitis. Therefore, the aim of this study was to investigate whether PEIDF could reduce the morbidity rates for patients with infectious spondylodiscitis. Methods: We launched a retrospective cohort study on the comparison of the perioperative prognosis between PEIDF and conventional open surgery for single-level lumbar infectious spondylodiscitis in patients with poor physical health (ASA ≥ 4) from 2014 to 2019. Results: Forty-four patients were included in this study. Fifteen of them underwent PEIDF, and the rest of the 29 patients were treated with open surgery. Less surgical blood loss (p < 0.001) and intraoperative transfusions (p < 0.001) with a better decline of CRP (p = 0.017) were statistically significant in patients receiving PEIDF. Patients undergoing conventional open surgery encountered more postoperative sepsis (p = 0.030), a higher qSOFA score (p = 0.044), and prolonged-time for CRP normalization (p = 0.001). Conclusions: PEIDF minimizes a poor postoperative outcome due to less surgical trauma, intraoperative blood loss, and the need for a blood transfusion.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines10071659