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Abstract：
BACKGROUND Pyogenic spondylodiscitis is infection of the intervertebral disc or discs and the adjacent vertebrae. This retrospective study aimed to compare the effectiveness of percutaneous endoscopic lumbar debridement (PELD) versus posterior lumbar interbody fusion (PLIF) in 40 patients with pyogenic spondylodiscitis (PSD). MATERIAL AND METHODS Medical records of patients who underwent PELD (n=18) or PLIF (n=22) for PSD between 2018 and 2023 were reviewed. The recorded outcomes encompassed surgical duration, intraoperative blood loss, Oswestry Disability Index (ODI) measurements, Visual Analog Scale (VAS) assessments, C-reactive protein (CRP) levels, duration of hospitalization, erythrocyte sedimentation rate (ESR), American Spinal Injury Association (ASIA) grading, lumbar sagittal parameters, and the incidence of complications. RESULTS The PELD group had shorter surgical duration, less intraoperative blood loss, and shorter length of hospital stay compared to the PLIF group (P<0.01). At the last follow-up, both groups had significant improvement in ESR, CRP levels, and ASIA classification (P<0.001), but there was no significant difference between the 2 groups (P>0.05). The PELD group had lower ODI and VAS ratings at 1 month and 3 months, respectively (P<0.01). The PLIF group had significant improvements in intervertebral space height and lumbar lordosis angle (P<0.01). CONCLUSIONS Both PLIF and PELD surgical approaches demonstrate adequate clinical efficacy in the treatment of monosegmental PSD. PLIF can better ensure more spinal stability than PELD, but PELD offers advantages such as reduced minimal surgical trauma, shorter operative duration, and faster recovery after surgery.
摘要：
背景技术化脓性脊椎盘炎是一种或多种椎间盘以及相邻椎骨的感染。这项回顾性研究旨在比较经皮内镜下腰椎清创术（PELD）与后路腰椎椎间融合术（PLIF）对40例化脓性椎间盘炎（PSD）患者的疗效。材料与方法回顾了2018年至2023年因PSD接受PELD（n=18）或PLIF（n=22）的患者的病历。记录的结果包括手术持续时间，术中失血,Oswestry残疾指数(ODI)测量，视觉模拟量表（VAS）评估，C反应蛋白(CRP)水平,住院时间，红细胞沉降率（ESR），美国脊髓损伤协会（ASIA）分级，腰椎矢状参数,以及并发症的发生率。结果PELD组手术时间较短,术中失血少,与PLIF组相比，住院时间短（P<0.01）。在最后一次随访中，两组ESR均有显著改善,CRP水平,和ASIA分类(P<0.001)，但两组间差异无统计学意义(P>0.05)。PELD组在1个月和3个月时的ODI和VAS评分较低，分别为(P<0.01)。PLIF组椎间隙高度、腰椎前凸角度均有显著改善(P<0.01)。结论PLIF和PELD两种手术方式在治疗单节段PSD方面均显示出足够的临床疗效。PLIF可以比PELD更好地确保更多的脊柱稳定性，但PELD提供的优势，如减少最小的手术创伤，手术持续时间较短，手术后恢复更快。
