title: Rigid Posterior Lumbopelvic Fixation without Formal Debridement for Pyogenic Vertebral Diskitis and Osteomyelitis Involving the Lumbosacral Junction: Technical Report.
abstract: BACKGROUND
  Pelvic fixation with S2-alar-iliac (S2AI) screws can increase the rigidity of a lumbosacral construct, which may promote bone healing, improve antibiotic delivery to infected tissues, and avoid L5-S1 pseudarthrosis.
  
  
  OBJECTIVE
  To describe the use of single-stage posterior fixation without debridement for the treatment of pyogenic vertebral diskitis and osteomyelitis (PVDO) at the lumbosacral junction.
  
  
  METHODS
  Technical report.
  
  
  METHODS
  We describe the management of PVDO at the lumbosacral junction in which the infection invaded the endplates, disk space, vertebrae, prevertebral soft tissues, and epidural space. Pedicle involvement precluded screw fixation at L5. Surgical management consisted of a single-stage posterior operation with rigid lumbopelvic fixation augmented with S2-alar-iliac screws and without formal debridement of the infected area, followed by long-term antibiotic treatment.
  
  
  RESULTS
  At 2-year follow-up, successful fusion and eradication of the infection were achieved.
  
  
  CONCLUSIONS
  PVDO at the lumbosacral junction may be treated successfully using rigid posterior-only fixation without formal debridement combined with antibiotic therapy.
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah , Salt Lake City, UT , USA.
authors.forename: Marcus D
authors.initials: MD
authors.lastname: Mazur
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah , Salt Lake City, UT , USA.
authors.forename: Vijay M
authors.initials: VM
authors.lastname: Ravindra
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah , Salt Lake City, UT , USA.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Dailey
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah , Salt Lake City, UT , USA.
authors.forename: Sara
authors.initials: S
authors.lastname: McEvoy
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah , Salt Lake City, UT , USA.
authors.forename: Meic H
authors.initials: MH
authors.lastname: Schmidt
keywords: S2-alar-iliac screw; diskitis; lumbosacral; osteomyelitis; pelvic fixation; posterior; pyogenic