Q 热合并脊柱感染患者的外科管理

Objective: To explore the effectiveness and evaluate the advantages and disadvantages of antimicrobial drugs combined with percutaneous transforaminal endoscopic spinal debridement with catheter drainage for the treatment of patients with Q fever combined with spinal infection. Methods: A retrospective analysis was conducted on the clinical data of 11 patients with Q fever combined with spinal infection at Qingdao Central Hospital from April 2015 to July 2023. Seven patients were treated with antimicrobial drugs alone (drug treatment group), and four patients were treated with a combination of antimicrobial drugs and percutaneous transforaminal endoscopic spinal debridement with catheter drainage (combined treatment group). The recovery of body temperature and improvement in pain symptoms were compared between the two groups, along with follow-up observations on the recurrence of the infection and functional recovery. Results: All patients were followed up for 6-24 months, with an average of (11.9 ± 4.7) months. The combined treatment group exhibited significant earlier normalization of body temperature and pain relief compared to the drug treatment group (all P<0.05). There was no statistically significant difference in visual analog scale (VAS) scores for pain or the Oswestry Disability Index (ODI) between the two groups at three months post-surgery or at the final follow-up (all P>0.05). The recurrence rates of infection were also similar between the two groups (P>0.05). Conclusions: The treatment of with combination of antimicrobial drugs and percutaneous transforaminal endoscopic spinal debridement with catheter drainage can achieve early infection control and symptom relief in patients with Q fever complicated with spinal infection, reducing damage to spinal structure and function.