Clinical Efficacy and Imaging Analysis for the Surgical Treatment of Thoracolumbar Infections in Elderly Patients
Abstract BackgroundFew reports have been conducted to comparing surgical results and safety evaluations between the different types of infections in geriatric patients. The aim of this study is to investigate the safety and efficacy of surgical treatment for thoracolumbar infections in elderly patients.Methods21 patients with pyogenic spondylodiscitis (PS) and 26 patients with tuberculous spondylodiscitis (TS) were enrolled in the study. All patients were treated using one-stage posterior debridement, decompression, and pedicle screw fixation. Comparison of operative safety parameters between the two groups. Clinical efficacy was evaluated using visual analog scale (VAS) score, the American Spinal Injury Association (ASIA) grade, the short form (SF)-36 survey and Oswestry disability index (ODI) to determine patient quality of life pre- and post-operatively. Results Hospitalisation and intensive care unit duration in the PS group were significantly shorter than in the TS group (P<0.05). The total incidence of post-operative complications for both groups was 44.7%. More complications occurred in the TS group, but the difference was not significant. The VAS and SF-36 scores (physical component) were significantly better in the PS group six months post-operatively, and the SF-36 (mental component) scores were significantly better in the PS group at the one-year follow-up. Neurological status in both groups improved post-operatively, and 83% of the patients were satisfied with the results of their operation. Imaging results showed that bone graft fusion improved in both groups at six months, one year and at the final follow-up. ConclusionSurgical treatment can provide satisfactory clinical and imaging results for thoracolumbar infection in patients over 65 years old. Although the incidence of peri-operative complications in the elderly is high, it is controllable and surgical treatment remains a safe and effective measure.