负压封闭引流术在脊柱后路内固定术后深部感染治疗中的应用

目的探讨负压封闭引流（vacuum sealing drainage，VSD）在治疗脊柱后路内固定术术后感染中的应用价值。方法回顾性分析2006年1月～2009年12月应用VSD治疗11例脊柱内固定术术后深部感染患者的治疗经过，以总结出合理的诊疗方法。结果11例患者应用VSD技术处理创面1～3次，每次引流7—10d。10例患者保留椎间植骨融合器、椎弓根钉、连接棒，仅取出横连。1例患者术中发现内固定已松动，取出所有内固定。随访6～36个月，所有患者均获得临床治愈。结论VSD技术可以充分引流脊柱后路内固定术术后深部感染伤口的脓液并消灭其死腔；同时增加了取出横连保留其他内固定的安全性，有利于切口早习愈合及尽早进行功能锻炼。

Vacuum sealing drainage for deep infection after posterior spinal internal fixation

Objective To evaluate the value of vacuum sealing drainage (VSD) for deep infection after posterior spinal internal fixation. Methods A tatal of 11 patients with deep infection after posterior spinal internal fixation that underwent VSD from January 2006 to December 2009 were analyzed retrospectively, of whom the diagnose and treatment was summarized in order to find the appropriate way. Results All the patients were treated by VSD for once to three times, and the drainage continued 7-10 d every time. The fusion devices and screw-rods were reserved while transverse links were taken out in 10 cases. Internal fixators were removed in 1 case because of loosening. All the patients were followed up for 6-36 months and all the cases were cured. Conclusion The pus and dead space of the infection after posterior spinal internal fixation can be eliminated by VSD; while removing of transverse link and reserving the implant can be safe, and wound healing and functional exercise can be earlier.