Successful treatment of spondylodiscitis using titanium cages: a 3-year follow-up of 22 consecutive patients.
OBJECTIVE
The use of metal implants in large defects caused by spinal infection to support the anterior column is controversial, and relatively few results have been published to date. Despite the fact that there is bacterial adhesion to metal implants, the strong immunity of the highly vascularized spine because of rich muscle covering is unique. This possibly allows the use of metal implants, which have the advantage of high stability and reduced loss of correction. This is a retrospective study of patients with spondylodiscitis treated with metal implants.


METHODS
We retrospectively analyzed the outcome in 22 consecutive patients (mean age 69 (43-82) years, 15 men) with spondylodiscitis (20 lumbar and 12 thoracic discs) who had received an anterior titanium cage implantation. In 13 cases, the pathogen could be identified. Antibiotic treatment was continued for at least 12 weeks postoperatively.


RESULTS
The mean follow-up was 36 (32-47) months. Healing of inflammation was confirmed by clinical, radiographic, and laboratory parameters. The mean VAS improved from 9.1 (6-10) preoperatively to 2.6 (0-6) at the final follow-up, and the mean Oswestry disability index was 17 (0-76) at the final follow-up.


CONCLUSIONS
Our findings highlight the high healing rate and stability when titanium implants are used. Prerequisites are a radical debridement, correction of deformity, and additional bony fusion by bone grafting. The increased stability, with facilitated patient mobilization, and the relatively little loss of correction using anterior and posterior implants are of considerable advantage in the treatment of the patients with multiple co-morbidities.
Spine Unit, Centre for Trauma- and Reconstructive Surgery, Charite-Campus Benjamin Franklin, Berlin, Germany. yohan.robinson@surgsci.uu.se
Yohan
Y
Robinson
Sven Kevin
SK
Tschoeke
Thomas
T
Finke
Ralph
R
Kayser
Wolfgang
W
Ertel
Christoph E
CE
Heyde
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015299:Discitis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D014025:Titanium; D016896:Treatment Outcome
D014025:Titanium