Application of Piezosurgery in Revision Surgery through Posterior Approach for Infection after Percutaneous Vertebral...

Area of Science:

• Spine surgery
• Orthopedic surgery
• Infectious disease management

Background:

• Pyogenic spondylitis after vertebral augmentation (PSVA) is a severe complication.
• Managing infectious bone cement in PSVA poses significant surgical challenges.
• Piezosurgery is effective for infectious bone cement removal in other spinal procedures but rarely used in PSVA.

Purpose of the Study:

• To introduce the application of piezosurgery in revision surgery for PSVA.
• To report preliminary radiological and clinical outcomes of piezosurgery in PSVA.
• To evaluate the efficacy and safety of piezosurgery for infectious bone cement removal in PSVA.

Main Methods:

• Retrospective review of nine PSVA patients undergoing revision surgery with piezosurgery.
• Description of piezosurgery technique for infectious bone cement removal and spinal reconstruction.
• Assessment of surgical time, blood loss, radiographic outcomes, infection control, bone fusion, and clinical outcomes (VAS, ODI, Odom's criteria).

Main Results:

• All patients had satisfactory bone cement removal and spinal alignment restoration.
• Significant improvements in Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores postoperatively.
• All patients achieved good outcomes according to Odom's criteria with satisfactory results.

Conclusions:

• Piezosurgery enables effective removal of infectious bone cement via a posterior approach in PSVA.
• The technique avoids damage to nerves and the spinal cord.
• A one-stage posterior approach using piezosurgery is a potential alternative treatment for PSVA.