Objective To explore the clinical efficacy of oblique lumbar interbody fusion (OLIF) in the treatment of single segment lumbar pyogenic spondylodiscitis. Methods From January 2014 to November 2018, patients with single level lumbar pyogenic spondylodiscitis treated by OLIF which contained debridement, iliac bone grafting and lateral screw fixation in our hospital were retrospectively analyzed. There were 21 males and 11 females with age of (59.0±1.9) years (38-78 years). There were 2 cases of L1/2, 7 cases of L2/3, 13 cases of L3/4 and 10 cases of L4/5. Preoperative Pola type included 3 cases of A.3 type, 1 case of A.4 type, 13 cases of B.1 type, 7 cases of B.2 type, 2 cases of B.3 type and 6 cases of C.1 type. Preoperative American Spinal Injury Association (ASIA) included 2 cases of C grade, 4 cases of D grade and 26 cases of E grade. Operation time, intraoperative blood loss, pathogen culture results and hospital days were recorded. The visual analogue scale (VAS), Oswestry disability index (ODI), white blood cell (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), global lumbar lordosis angle (GLL), disc space height (DSH), segmental lumbar lordosis angle (SLL), as well as complications and fusion before and 3 months and 18 months after operation were collected. Results All patients completed the operation successfully and the operation time was (92.8±12.4) min, the intraoperative blood loss was (108.5±32.9) mL. A total of 10 patients underwent CT guided bacterial culture of puncture specimens before operation and 6 cases (6/10, 60.0%) were positive. A total of 25 cases (25/32, 78.1%) of pathogens were detected by intraoperative culture. The hospital day was (13.6±2.1) d and the follow-up time was (21.1±2.0) months. At 3 and 18 months of follow-up, VAS and ODI were significantly lower than those before operation (P<0.05), and WBC, CRP, ESR and PCT were also significantly lower than those before operation (P<0.05), GLL, DSH and SLL were significantly higher than those before operation (P<0.05). There were only 1 case of D grade who did not recover completely at 18 months postoperation. All patients achieved bone fusion and no operation related complications occurred at the last follow-up. Conclusion OLIF in the treatment of single segment lumbar pyogenic spondylodiscitis can achieve good clinical and imaging results, especially for Pola type A.3-C.1 type. This is worthy of further promotion and application. |