Surgical treatment of spondylodiscitis.
BACKGROUND: Spondylodiscitis is a rare bacterial infection of the vertebra and intervertebral discs with an inflammatory, destructive course. METHODS: To gain further information about the management and clinical course of spondylodiscitis, we retrospectively reviewed 32 patients in 2002 who had surgical interventions between 1992 and 2001. RESULTS: The mean age of patients was 61 years (29-78 years). The mean hospital stay was 47 days (+/- 5.6 days; 3-121 days), including 28 days (+/- 8.1 days; 2-112 days) in the ICU. In-hospital mortality was 6%. The cervical spine was affected in 20% of patients (6/32), the thoracic spine in 25% (8/32), and the lumbosacral spine in 55% (18/32). Abscesses occurred in 63% of patients (20/32) and destruction of the vertebral body in 71% (23/32). Neurological deficits were present in 17 patients, which improved by surgical intervention in 82% of those affected. Thirty-one patients underwent ventral resection of the focus, spondylodesis with a bone graft or titanium cage, and ventral stabilization with a plate. In 19% of patients (6/32), additional dorsal bridging instrumentation was performed. Complete healing was obtained in 94% (30/32) patients. At follow-up, 50% of patients (16/32) had no complaints. CONCLUSIONS: Spondylodiscitis requires immediate debridement of the focus, with decompression and stabilization through a ventral approach, when conservative management fails. Otherwise, severe complications occur, such as sepsis, vertebral body destruction, abscess, or neurological deficits.[1]References
- Surgical treatment of spondylodiscitis. Schinkel, C., Gottwald, M., Andress, H.J. Surgical infections. (2003) [Pubmed]
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