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Lower-body amputation effective in extreme cases of bone infection

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Translumbar amputation in cases of severe pelvic bone infections can help patients survive longer with a higher quality of life, according to researchers with the University of Texas Southwestern Medical Center.

Though the amputation has rarely been performed due to very limited indications for the procedure, one-third of the 66 cases investigated by researchers survived at least 9 years after the procedure. More than half of those who underwent the procedure to combat bone infection survived at least 9 years, and of the nine terminal pelvic osteomyelitis-driven patients treated at the university, four remained alive after 25 years. Average survival was 11 years.

“We determined it can be effective and a reasonable consideration in some of these extreme cases,” stated lead study author Jeffrey E. Janis, MD, in a press release.

Only 57 cases of translumbar amputations had been recorded in medical literature worldwide at the time of the study, though researchers suspect more have occurred since the initial referencing in 1960. The authors added to the review nine patients of their own – all of whom had received the procedure as a result of terminal pelvic osteomyelitis.

The authors cited an increasing number of veterans of the conflicts in Iraq and Afghanistan surviving severe injuries that lead to permanent paraplegia as one reason the number of translumbar amputations may increase in the future. Bedsores and bone infections are frequent complications for these patients.

“Though it is impossible to know how the survival rate would compare had these patients not undergone the amputation, given the severe disease involved, it is reasonable to assume they survived longer than they would have without surgery,” Janis stated in the release.

“Most importantly, our survivors reported that they were satisfied with their decision to have the procedure,” he added.

For more information:

http://www.utsouthwestern.edu/utsw/cda/dept37389/files/563263.html