title: Surgical Treatment in Patients with Cervical Osteomyelitis: Single Institute's Experiences.
abstract: OBJECTIVE
  To study practical guidelines and strategies in the treatment of cervical osteomyelitis.
  
  
  METHODS
  We retrospectively reviewed 14 patients who underwent surgical treatment for cervical osteomyelitis from May 2000 to July 2008. We investigated their clinical course, antibiotic regimen, surgical methods, and laboratory and radiologic findings including X-ray, CT and MRI.
  
  
  RESULTS
  5 patients had primary spondylodiscitis, 5 patients had post operative spondylodiscitis and 4 patients had tuberculosis in cervical spine. The causative microorganisms were MRSA (5), P. aeruginosa (1), Methicillin resistant coagulase negative streptococcus (1), P. aeruginosa changed to MRSA (1), and 2 patients showed no growth on culture studies. Patients were treated 13.8 weeks (range, 5.4-25.8) with IV antibiotics and then treated for 58.2 days (range, 13-106) with oral antibiotics. Antituberculotic medications were used for a mean of 383.8 days. Patients were treated with anterior debridement and fusion (5), irrigation and debridement (5), simultaneous cervical anterior interbody and transthoracic thoracic interbody fusion (1). 3 patients underwent the planned 2-staged operation, which included an anterior debridement with or without fusion for the 1(st) operation and posterior instrumentation for 2(nd) operation. 10 patients (71.4%) had neurologic deficits at the time of diagnosis and 7 patients (70%) among them improved post-operatively.
  
  
  CONCLUSIONS
  Anterior cervical spine surgery is the preferable treatment option in patients with neurological deterioration, extensive bony destruction with expected kyphotic deformity, and uncontrolled infection being managed only with antibiotics. Antibiotics are also important for thorough treatment.
authors.affiliation: Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Bang Sang
authors.initials: BS
authors.lastname: Hahn
authors.affiliation: Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyung-Hyun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sung-Uk
authors.initials: SU
authors.lastname: Kuh
authors.affiliation: Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung Yoon
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dong-Kyu
authors.initials: DK
authors.lastname: Chin
authors.affiliation: Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Keun-Su
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong-Eun
authors.initials: YE
authors.lastname: Cho
keywords: Cervical spine; Osteomyelitis; Spinal infection; Spondylodiscitis