经椎间孔镜技术结合宏基因二代测序技术治疗脊柱感染的疗效  

Treatment of spinal infections through the combination of transforaminal endoscopic technique and metagenomic second-generation sequencing technology

作　　者：束晖 吴树华[1] 王遥伟[1] 贺双军 荆瑜鹏 周立建[1] SHU Hui;WU Shuhua;WANG Yaowei;HE Shuangjun;JING Yupeng;ZHOU Lijian(Department of Orthopedics,Danyang People′s Hospital Affiliated to Nantong University,Danyang 212300)

机构地区：[1]南通大学附属丹阳市人民医院骨科,丹阳212300

出　　处：《颈腰痛杂志》2025年第2期338-341,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：江苏省老年健康科研课题项目(LKM2022083)。

摘　　要：目的探讨经椎间孔镜技术结合宏基因二代测序(mNGS)技术治疗脊柱感染的疗效。方法回顾性分析本院2022年1月至2023年6月9例脊柱感染病例,采用经皮椎间孔镜下取活检并行病灶清除,行微生物学检查和mNGS检测,根据结果行抗感染治疗,并分析治疗后1周与治疗后3个月,患者的疼痛视觉模拟量表(VAS)评分、日本骨科协会(JOA)评分、Oswestry功能障碍指数(ODI)。结果9例患者中,化脓性细菌感染6例,布鲁氏菌感染1例,真菌感染1例,病原学阴性1例。实验室检测结果阳性率55.6%(5/9),mNGS检测结果的阳性率88.9%(8/9),差异有统计学意义(P<0.05)。治疗后1周与治疗后3个月,患者的VAS评分、JOA评分、ODI术前明显改善,差异有统计学意义(P<0.05)。结论经椎间孔镜技术结合mNGS检测治疗脊柱感染,创伤小,病原学诊断价值较高,可取得良好的疗效。Objective To explore the efficacy of intervertebral foramen endoscopy combined with metagenomic next-generation sequencing(mNGS)technology in the treatment of spinal infection.Methods A retrospective analysis was conducted on 9 cases of spinal infection in our hospital from January 2022 to June 2023.Percutaneous foramen biopsy and lesion clearance were performed,microbiological examination and mNGS detection were performed,and anti infection treatment was performed based on the results.The patient’s pain visual analog scale(VAS)score,Japanese Orthopaedic Association(JOA)score,and Oswestry disability index(ODI)were analyzed 1 week and 3 months after treatment.Results Among 9 patients,there were 6 cases of suppurative bacterial infection,1 case of brucella infection,1 case of fungal infection,and 1 case of pathogen negative.The positive rate of laboratory test results was 55.6%(5/9),while the positive rate of mNGS test results was 88.9%(8/9),with a statistically significant difference(P<0.05).After 1 week and 3 months of treatment,the VAS score,JOA score,and ODI functional index of the patients were significantly improved compared to before surgery,with a statistically significant difference(P<0.05).Conclusion The combination of intervertebral foramen endoscopy and mNGS detection in the treatment of spinal infection has low trauma,high diagnostic value in etiology,and can achieve good therapeutic effects.

关 键 词：椎间孔镜技术 脊柱感染 宏基因组二代测序 病原微生物 微生物培养 抗感染 

分 类 号：R681.5[医药卫生—骨科学]