Salvage reconstruction in acute and late sequelae from pyogenic thoracolumbar infection.
Nine patients treated surgically for complicated pyogenic osteomyelitis of the thoracolumbar spine are reported. All patients were treated with anterior debridement and stabilization with nonvascularized autogenous fibular strut grafts. In addition, seven underwent a posterior spinal fusion with instrumentation. The average length of follow-up was 25 months. There was no recurrence of infection, no pseudoarthrosis, and the fibular struts appeared incorporated in all patients. Seven patients had postoperative improvement or resolution of their back pain. The use of nonvascularized autogenous fibular strut grafts for reconstruction of the spine following debridement for vertebral osteomyelitis is an effective procedure. The advantages of using the fibula for grafting are its strength and length for spanning several vertebral segments, and it can provide multiple grafts.
Graziano
G P
GP
Section of Orthopaedic Surgery, University of Michigan Hospitals, Ann Arbor 48109-0328.
Sidhu
K S
KS
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology / Q000601:surgery*; D016025:Bone Transplantation; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007403:Intervertebral Disc / Q000601:surgery; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000150:complications / Q000601:surgery* / Q000628:therapy; D010264:Paraplegia / Q000209:etiology / Q000601:surgery*; D012480:Salmonella Infections / Q000150:complications / Q000601:surgery / Q000628:therapy; D012720:Severity of Illness Index; D013123:Spinal Fusion; D013166:Spondylitis / Q000150:complications / Q000601:surgery* / Q000628:therapy; D013203:Staphylococcal Infections / Q000150:complications / Q000601:surgery / Q000628:therapy; D013904:Thoracic Vertebrae / Q000601:surgery*
D000900:Anti-Bacterial Agents