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已发表论文
内镜下腹膜后清创术联合后路经皮椎弓根螺钉固定治疗腰椎感染性脊柱椎间盘炎：一项回顾性研究及初步结果
Authors Yang Y, Ruan W, Li J, Dang R, An H, Zhao W, Xu L, Tan H
Received 28 October 2025
Accepted for publication 15 December 2025
Published 31 December 2025 Volume 2025:18 Pages 18331—18342
DOI https://doi.org/10.2147/JIR.S574973
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Ujjwol Risal
Yongrui Yang, Wenkai Ruan, Jianlong Li, Rongpan Dang, Huigang An, Wentao Zhao, Liang Xu, Hongdong Tan
Department of Orthopedics, Shandong Public Health Clinical Center, Shandong University, Jinan, Shandong, 250013, People’s Republic of China
Correspondence: Hongdong Tan, Email Tanhd_1218@163.com
Background: Lumbar infectious spondylodiscitis is a severe spinal condition traditionally managed with antibiotics, though some patients require surgical intervention. The heterogeneity in infection sites, causative pathogens, and clinical presentations leads to significant variability in surgical approaches, and optimal surgical strategies remain controversial. This study aims to evaluate the feasibility, safety, and preliminary efficacy of endoscopic retroperitoneal debridement combined with posterior percutaneous pedicle screw fixation for the treatment of lumbar infectious spondylodiscitis.
Methods: This retrospective study analyzed patients diagnosed with lumbar infectious spondylodiscitis and treated with endoscopic retroperitoneal debridement at our institution from June 2023 to June 2024. Baseline patient characteristics, operative time, intraoperative blood loss, postoperative lesion clearance, changes in inflammatory markers (eg, C-reactive protein[CRP] and erythrocyte sedimentation rate[ESR]), complication rates, Visual analog scale (VAS) scores for back pain, Oswestry Disability Index (ODI) scores, kyphotic angle changes at the infected level, and radiological follow-up outcomes were recorded.
Results: Of the 30 patients, 28 (28/30, 93.33%) showed improvement in clinical symptoms. During follow-up, all patients demonstrated significant improvements in VAS scores and ODI scores compared to preoperative values (p< 0.05). At the final follow-up, all patients exhibited a kyphotic angle change of less than 8°, and no spinal instability was observed. Computed tomography (CT) at the 12-month follow-up demonstrated intervertebral bone fusion in 27 cases (27/29, 93.10%). Postoperative inflammatory markers showed improved compared with preoperative levels (p< 0.001). No infection recurrence or serious surgery-related complications were observed during the postoperative follow-up period.
Conclusion: Endoscopic retroperitoneal debridement combined with posterior percutaneous pedicle screw fixation appears to be a safe and effective minimally invasive approach for treating lumbar infectious spondylodiscitis. However, long-term efficacy requires further validation through prospective studies with larger sample sizes and extended follow-up periods.
Keywords: endoscopic retroperitoneal debridement, lumbar infectious spondylodiscitis, endoscopic technology, minimally invasive surgery
Department of Orthopedics, Shandong Public Health Clinical Center, Shandong University, Jinan, Shandong, 250013, People’s Republic of China
Correspondence: Hongdong Tan, Email Tanhd_1218@163.com
Background: Lumbar infectious spondylodiscitis is a severe spinal condition traditionally managed with antibiotics, though some patients require surgical intervention. The heterogeneity in infection sites, causative pathogens, and clinical presentations leads to significant variability in surgical approaches, and optimal surgical strategies remain controversial. This study aims to evaluate the feasibility, safety, and preliminary efficacy of endoscopic retroperitoneal debridement combined with posterior percutaneous pedicle screw fixation for the treatment of lumbar infectious spondylodiscitis.
Methods: This retrospective study analyzed patients diagnosed with lumbar infectious spondylodiscitis and treated with endoscopic retroperitoneal debridement at our institution from June 2023 to June 2024. Baseline patient characteristics, operative time, intraoperative blood loss, postoperative lesion clearance, changes in inflammatory markers (eg, C-reactive protein[CRP] and erythrocyte sedimentation rate[ESR]), complication rates, Visual analog scale (VAS) scores for back pain, Oswestry Disability Index (ODI) scores, kyphotic angle changes at the infected level, and radiological follow-up outcomes were recorded.
Results: Of the 30 patients, 28 (28/30, 93.33%) showed improvement in clinical symptoms. During follow-up, all patients demonstrated significant improvements in VAS scores and ODI scores compared to preoperative values (p< 0.05). At the final follow-up, all patients exhibited a kyphotic angle change of less than 8°, and no spinal instability was observed. Computed tomography (CT) at the 12-month follow-up demonstrated intervertebral bone fusion in 27 cases (27/29, 93.10%). Postoperative inflammatory markers showed improved compared with preoperative levels (p< 0.001). No infection recurrence or serious surgery-related complications were observed during the postoperative follow-up period.
Conclusion: Endoscopic retroperitoneal debridement combined with posterior percutaneous pedicle screw fixation appears to be a safe and effective minimally invasive approach for treating lumbar infectious spondylodiscitis. However, long-term efficacy requires further validation through prospective studies with larger sample sizes and extended follow-up periods.
Keywords: endoscopic retroperitoneal debridement, lumbar infectious spondylodiscitis, endoscopic technology, minimally invasive surgery