Wu JJ, Chang ZQ. Treatment of refractory thoracolumbar spine infection by thirteen times of vacuum sealing drainage: A case report. World J Orthop 2025; 16(3): 101073 [PMID: 40124728 DOI: 10.5312/wjo.v16.i3.101073]
Corresponding Author of This Article
Zheng-Qi Chang, MD, PhD, Associate Professor, Chief Doctor, Department of Orthopedics, 960th Hospital of PLA, No. 25 Shifan Road, Tianqiao District, Jinan 250031, Shandong Province, China. 26766771@qq.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Mar 18, 2025; 16(3): 101073 Published online Mar 18, 2025. doi: 10.5312/wjo.v16.i3.101073
Treatment of refractory thoracolumbar spine infection by thirteen times of vacuum sealing drainage: A case report
Jun-Jie Wu, Zheng-Qi Chang
Jun-Jie Wu, Zheng-Qi Chang, Department of Orthopedics, 960th Hospital of PLA, Jinan 250031, Shandong Province, China
Author contributions: Wu JJ and Chang ZQ made substantial contributions to acquisition, analysis and interpretation of data; Chang ZQ was responsible for the conception and design of the study; Wu JJ was responsible for the drafting and writing of this manuscript; Wu JJ assisted Chang ZQ in completing the operation. All authors confirm the authenticity of all the raw data.
Supported by Natural Science Foundation of Shandong Province, No. ZR2023MH331.
Informed consent statement: Written informed consent was obtained from the patient for publication and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of Interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zheng-Qi Chang, MD, PhD, Associate Professor, Chief Doctor, Department of Orthopedics, 960th Hospital of PLA, No. 25 Shifan Road, Tianqiao District, Jinan 250031, Shandong Province, China. 26766771@qq.com
Received: September 3, 2024 Revised: January 7, 2025 Accepted: February 12, 2025 Published online: March 18, 2025 Processing time: 189 Days and 15.5 Hours
Abstract
BACKGROUND
A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage (VSD) surgeries were treated.
CASE SUMMARY
The patient underwent a total of 13 procedures within our medical facility, including five performed under local anesthesia and eight performed under general anesthesia. The source of the ailment was ultimately identified as Enterobacter cloacae. After the last procedure, the patient's symptoms were alleviated, and the recovery process was satisfactory. Three months post-operation, the Japanese Orthopaedic Association scores had improved to 100%. Imageological examination revealed a satisfactory position of internal fixation, and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.
CONCLUSION
The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection, providing an alternative to traditional surgery.
Core Tip: External approach was used to clear the infected lesion, and vacuum sealing drainage (VSD) was used to control lumbar infection. Previous studies have shown that incomplete clearance of lesions is the main cause of recurrent lumbar infections, and VSD can effectively address this issue. This case involves a jumping lesion, and Escherichia coli was isolated from the negative pressure drainage fluid of both lesions, indicating the feasibility of obtaining pathogenic microorganisms from negative pressure drainage fluid.
