PEEK cage cervical ventral fusion in spondylodiscitis.
OBJECTIVE
Cervical spondylodiscitis is a quite rare finding regarding the number and the common location of spinal abscesses in the lumbar region. While in thoracic and lumbar discitis, single-step surgery with neural decompression, disc space evacuation, and subsequent fusion is well known, there is no such report in cervical discitis. Here the authors present their experience with ventral polyetherketone (PEEK) cage fusion in cervical spondylodiscitis in a single-step procedure.


METHODS
Between January 2006 and November 2008, five patients (three men, two woman; ages 71, 77, 58, 66 and 66 years) suffering from cervical spondylodiscitis and epidural abscess underwent disc evacuation, myelon decompression and subsequent ventral fusion using an empty PEEK cage disc replacement in one single setting. All five patients presented with significant neurological symptoms like cervicobrachialgia, tetraparesis and disturbance of the urinary incontinence. In all five patients, disc evacuation, myelon decompression and cervical fusion using a PEEK cage disc replacement in a single-stage surgery were performed. All wounds were closed primarily. Postoperatively, all patients received a specific antibiotic therapy for at least 6 weeks.


RESULTS
This treatment strategy was successful in all patients with respect to clinical signs, laboratory parameters and radiological findings. All patients improved neurologically. Follow-up revealed a stable osteosynthesis without signs of instability. One cage was explanted despite neurological improvement and normal infectious parameters at another surgical department. No complications were observed.


CONCLUSIONS
In all, abscess drainage and ventral fusion with PEEK-cage disc replacement in one single setting was proven to be a successful treatment option in cervical discitis and spinal epidural abscess.
Mondorf
Yvonne
Y
Department of Neurosurgery, Nordstadtkrankenhaus, Hannover, Germany.
Gaab
Michael R
MR
Oertel
Joachim M K
JM
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001577:Benzophenones; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D015299:Discitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D020802:Epidural Abscess / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D007659:Ketones / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology; D010019:Osteomyelitis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011108:Polymers; D011183:Postoperative Complications; D019736:Prostheses and Implants; D011782:Quadriplegia / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology
D000900:Anti-Bacterial Agents; D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols