Bone infection as one of the most challenging diseases in orthopedics, is characterized by a prolonged treatment and a high recurrence rate, imposing a significant disease burden on both patients and society. With the continuous emergence of drug-resistant bacteria and a deepening understanding of biofilm theory, traditional single-modality treatment have become inadequate in addressing these complex clinical challenges. This paper provides an in-depth analysis of the century-long dilemma in the treatment of bone infections. Through systematic theory, it shares the author’s “Chongqing experiences” in bone infection management—a systematic strategy proposed based on extensive clinical practice and theoretical summarization. This approach emphasizes the importance of multi-disciplinary treatment, staged treatment, precise debridement, and a comprehensive grasp of the principles underlying bone infection therapy. The article also discusses humanistic considerations and future prospects in the treatment of bone infections, aiming to offer practical and valuable basis for clinical management.
Objective To investigate the therapeutic effectof the modified anterior approach in treatment of the patients with cervicothoracic junction spinal lesions. Methods From September 2000 to January 2005, 23 patients (15 males, 8 females) with spinal lesions in the cervicothoracic junction underwent a standard cervical approach, which was combined with apartial median steotomy and transverse steotomy through the synostosis between the manubrium and body of the sternum to expose the lesion adequately. Among thepatients, 3 had fracture, 7 had dislocation, 6 had tuberculosis, and 7 had tumor. The pathologic change regions was as follows: 2 in the C6-T1 segment, 2in the C6-T2 segment, 3 in the C7-T1 segment, 3 in the T3 segment, 8 in the T1 segment, and 5 in the T2egment. The classification of Frankel were as follows: 2 at grade A, 4 at grade B, 7 at grade C, 4 at grade D, and 6 at grade E. All the patients underwent a radical excision of the affected spinal bone, were given a proper tricortical iliac crest and anterior instrumentation to reconstruct the anterior spinal column, followed by immobilization in a brace for 3-6 months. Results The mean followup period was 30 months (range, 1042 months). Bony fusion was obtained in all the patients.One patient died of pulmonary cancer metastasis 10 months after operation. The nerve function of the spinal cord recovered at different degrees (1 at grade A, None at grade B, 2 at grade C, 10 at grade D, 10 at grade E). Conclusion Ourmodified anterior approach can provide a direct and safe access to the lesions in the region.