Single-stage posterior debridement and single-level instrumented fusion for spontaneous infectious spondylodiscitis of the lumbar spine.
Spontaneous infectious spondylodiscitis (SIS) is an uncommon condition. The purpose of this retrospective study of 10 adult patients (6 males and 4 females, average age 52 years), all with lumbar SIS and epidural abscess, was to analyze the efficacy of single-stage posterior debridement plus single-level interbody grafting with autologous bone, and transpedicular screw-rod instrumentation. The mean follow-up period was 43 months, with a minimum of 30 months. The back pain was relieved within 3 to 8 days after surgery. Neurologic deficits, present in 5 cases, all improved. Solid fusion was achieved at 6 months in all 10 cases. The mean VAS for pain improved from 7.5 to 1.6, the mean Oswestry Disability Index from 57.8% to 8.1%. The mean physical component of SF-36 (PCS) improved from 32.4% to 54.7%, the mean mental component of SF-36 (MCS) improved from 33.8% to 57.2%. All these changes were significant (p < 0.001). No recurrence of infection was noted. The outcome was quite satisfactory in terms of fusion rate and quality of life.
Dept of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Liang
L
Zhang
Wei-Hua
WH
Cai
Bo
B
Huang
Lin-Wei
LW
Chen
Ning
N
Zhang
Bin
B
Ni
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications*; D003646:Debridement / Q000379:methods*; D015299:Discitis / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D020802:Epidural Abscess / Q000150:complications / Q000382:microbiology; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion / Q000379:methods*; D013166:Spondylitis / Q000382:microbiology / Q000601:surgery*