Anterior debridement and strut graft with pedicle screw fixation for pyogenic spondylitis.
METHODS
A retrospective study.


OBJECTIVE
We evaluated the results of the use of anterior debridement and interbody fusion followed by posterior spinal instrumentation.


BACKGROUND
An early diagnosis of pyogenic spondylitis is difficult to obtain. The disease can be treated with various surgical methods (such as anterior debridement and bone graft, anterior instrumentation, and posterior instrumentation).


METHODS
This study included 20 patients who received anterior debridement and interbody fusion with strut bone graft followed by posterior spinal fusion for pyogenic spondylitis between 1996 and 2005. We analyzed the culture studies, the correction of the kyphotic angle, blood chemistry, the bony union period, and the amount of symptom relief.


RESULTS
In terms of clinical symptoms relief, eight patients were grouped as "excellent", eleven patients as "good", and one patient as "fair". The vertebral body cultures were positive in 14 patients showing coagulase (-) streptococcus and S. aureus. The average times for normalization of the erythrocyte sedimentation rate and C-reactive protein level were 3.3 and 1.9 months, respectively. Four months was required for bony union. For complications, meralgia paresthetica was found in two cases.


CONCLUSIONS
Due to early ambulation and the correction of the kyphotic angle, anterior interbody fusion with strut bone graft and posterior instrumentation could be another favorable method for the treatment of pyogenic spondyulitis.
Shin
Dong-Eun
DE
Department of Orthopedic Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University, Korea.
Kim
Hak-Sun
HS
Ahn
Chang-Soo
CS
Lee
Dong-Hoon
DH
Lee
Soon-Chul
SC
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