The surgical treatment of pyogenic spondylitis using posterior instrumentation without anterior debridement.
There have been few reports regarding the efficacy of posterior instrumentation alone as surgical treatment for patients with pyogenic spondylitis, thus avoiding the morbidity of anterior surgery. We report the clinical outcomes of six patients with pyogenic spondylitis treated effectively with a single-stage posterior fusion without anterior debridement at a mean follow-up of 2.8 years (2 to 5). Haematological data, including white cell count and level of C-reactive protein, returned to normal in all patients at a mean of 8.2 weeks (7 to 9) after the posterior fusion. Rigid bony fusion between the infected vertebrae was observed in five patients at a mean of 6.3 months (4.5 to 8) post-operatively, with the remaining patient having partial union. Severe back pain was immediately reduced following surgery and the activities of daily living showed a marked improvement. Methicillin-resistant Staphylococcus aureus was detected as the causative organism in four patients. Single-stage posterior fusion may be effective in patients with pyogenic spondylitis who have relatively minor bony destruction.
Gifu University Graduate School of Medicine, Department of Orthopaedic Surgery, Yanagido 1-1, Gifu City, Gifu, 501-1194, Japan. fuship7@yahoo.co.jp
K
K
Fushimi
K
K
Miyamoto
S
S
Fukuta
H
H
Hosoe
T
T
Masuda
K
K
Shimizu
D000203:Activities of Daily Living; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003646:Debridement; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods* / Q000534:rehabilitation; D013166:Spondylitis / Q000175:diagnosis / Q000601:surgery*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome
D015415:Biomarkers; D002097:C-Reactive Protein