Clinical comparative study of four kinds of intervertebral bone graft fusion in treatment of pyogenic spondylitis
Objective To compare the clinical efficacy of four different interbody fusion methods for the treatment of pyogenic spondylitis.Methods From January 2016 to November 2022,a total of 106 cases of thoracolumbar pyogenic spondylitis were treated with one-stage posterior lesion clearance and interbody fusion fixation surgery at our hospitals.The clinical efficacy of four bone graft fusion methods was compared:autogenous iliac bone(group A),autogenous iliac bone combined with allograft(group B),autogenous iliac bone filled titanium cage(group C),and autogenous iliac bone filled polyetheretherketone interverte-bral fusion device(group D).Results All patients were followed up for 12 to 20 months,with an average of 16.5 months.There were no statistically significant differences in surgical time,intraoperative blood loss,postoperative drainage volume,and length of hospital stay among the four groups(P＞0.05).However,there was a statistically significant difference in hospitalization costs among the four groups(P＜0.05),with group A having the lowest costs followed by group B and then groups C and D.There were no statistically significant differences in preoperative and postoperative levels of C-reactive protein,erythrocyte sedimentation rate,white blood cell count,or calcitonin between the four groups at 7 days,1 month,and 3 months after surgery(P＞0.05).The incidence of postoperative infection recurrence did not differ significantly among the four groups(P＞0.05).There were no statis-tically significant differences in pain VAS scores at 1 month,6 months,and 12 months after surgery as well as JOA scores and ODI index between the four groups(P＞0.05).The ASIA classification at 12months after surgery also showed no statistically sig-nificant differences among the four groups(P＞0.05).The Cobb angle measurements before and after surgery,and at last follow-up did not show any statistically significant differences among the four groups(P＞0.05).The Cobb angle difference,Cobb angle correction rate,bone fusion rate,bone fusion time and bone graft subsidence also did not show any statistically significant differ-ences among the four groups(P＞0.05).Conclusion In patients with pyogenic spondylitis,it is safe and effective to use autog-enous iliac bone,autogenous iliac bone combined with allograft bone,autogenous iliac bone filled with titanium cage,autog-enous iliac bone filled with PEEK interbody fusion apparatus under the premise of complete removal of lesions,reliable spinal fusion internal fixation device and standard and effective anti-infection treatment.
Pyogenic spondylitisInterbody fusionBone graft material
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