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
Sheng-Fen Wang,
Tsung-Ting Tsai,
Yun-Da Li,
Ping-Yeh Chiu,
Ming-Kai Hsieh,
Jen-Chung Liao,
Po-Liang Lai,
Fu-Cheng Kao
Affiliations
Sheng-Fen Wang
Department of Anesthesiology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Tsung-Ting Tsai
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5, Fusing St., Gueishan, Taoyuan 333, Taiwan
Yun-Da Li
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5, Fusing St., Gueishan, Taoyuan 333, Taiwan
Ping-Yeh Chiu
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5, Fusing St., Gueishan, Taoyuan 333, Taiwan
Ming-Kai Hsieh
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5, Fusing St., Gueishan, Taoyuan 333, Taiwan
Jen-Chung Liao
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5, Fusing St., Gueishan, Taoyuan 333, Taiwan
Po-Liang Lai
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5, Fusing St., Gueishan, Taoyuan 333, Taiwan
Fu-Cheng Kao
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5, Fusing St., Gueishan, Taoyuan 333, Taiwan
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 p 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.