Minimally invasive surgery in Infectious spondylitis

NTRODUCTION. In recent years, there has been an increase in the frequency of nonspecific infectious diseases of the spine both in Russia and around the world. In modern conditions, in addition to surgical treatment of degenerative-dystrophic diseases of the spine, minimally invasive spinal surgery technologies have become actively introduced into the surgical treatment of infectious processes in the spine. Despite the widespread use of MISS technologies over the past decade, there are very few publications on this topic, most of the works describe small samples of patients (up to 10 patients), and there is no comparison of various minimally invasive surgical methods among themselves. AIM. The article deals with a review of the literature data and an analysis of results of the use of minimally invasive technologies in the surgical treatment of patients with infectious spondylitis. MATERIALS AND METHODS. During the period from 2019 to 2022, 28 patients with infectious lumbar spine spondylitis were operated on. The clinical picture was dominated by pain vertebrogenic syndrome and systemic inflammatory reaction syndrome. Patients underwent surgery using minimally invasive technologies (MISS): in group 1, 20 (71.4 %) patients underwent drainage of the infectious focus and decompression of the spinal canal by minimally invasive access using Caspar dilators and minilaminectomy, in group 2, 8 (28.6 %) patients underwent a set of tubes and a rigid endoscope through interlaminar or transforaminal access. RESULTS. Treatment results were evaluated dynamically using pain syndrome and quality of life assessment scales (NPS, ODI, MacNab), neuroimaging data, clinical and laboratory parameters. The results of surgical treatment in the first (MIS) group of patients were better than in the second (p<0.05). In 2 (25 %) patients of the 2 nd group who underwent endoscopic rehabilitation, the progression of the infectious process in the spine was revealed, which required repeated operations in this segment in the amount of decompression, rehabilitation and stabilization. CONCLUSION. The use of minimally invasive technologies in the surgical treatment of infectious spondylitis was not accompanied by the development of instability of the operated segment and the progression of neurological disorders in patients.

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