title: A Retrospective Study of 39 Patients Treated With Anterior Approach of Thoracic and Lumbar Spondylodiscitis: Clinical Manifestations, Anterior Surgical Treatment, and Outcome.
abstract: The aim of this study is to report our 39 patients treated with anterior debridement and autologous iliac bone grafting with or without anterior instrumentation, which is the presumed treatment of choice for thoracic or lumbar spondylodiscitis.Our patients underwent surgical treatment of spondylodiscitis using anterior debridement and autologous iliac bone grafting with or without anterior instrumentation and were analyzed with a mean follow-up of 8 years (range, 2-11 years). Kaneda 2-rod system instrumentation was used in 12 patients, in total. Clinical outcomes were assessed by the Frankel grade. Radiographic fusion was characterized based on 3-dimensional computed tomography.Of the whole group, 20 patients suffered from tuberculous spondylodiscitis and 19 suffered from hematogenous spondylodiscitis. Pathogens responsible for pyogenic infection included Staphylococcus aureus (4 patients), Pseudomonas aeruginosa (3 patients), and Brucella melitensis (1 patient). Fifteen patients had thoracic involvement, 20 had lumbar involvement, and 4 had thoracolumbar junction involvement. Preoperative neurological deficits were noted in 13 of the 39 patients. In terms of Frankel grade, 8 patients have improved, 4 have remained the same, and 1 patient has worsened during the follow-up period. Imaging-documented fusion was achieved in 23 of 27 patients in the graft group (85% fusion rate) and 11 of 12 patients in the graft + Kaneda instrumentation group (91% fusion rate).There was no instrumentation failure, loosening, or graft-related complication such as slippage or fracture of the graft. This approach demonstrated a good recovery rate of neurological functions and a high fusion rate.
authors.affiliation: From the Department of Neurosurgery, Sakarya University, Sakarya (CY); Department of Neurosurgery, Izmir Tepecik Training and Research Hospital, Izmir (NO); Department of Neurosurgery, Koc University, Istanbul (OY); Department of Neurosurgery, Izmir Atatürk Training and Research Hospital (HGF, MM); and Department of General Surgery, Izmir Atatürk Training and Research Hospital, İzmir, Turkey (TT).
authors.forename: Can
authors.initials: C
authors.lastname: Yaldz
authors.forename: Nail
authors.initials: N
authors.lastname: Özdemir
authors.forename: Onur
authors.initials: O
authors.lastname: Yaman
authors.forename: Hamit Günes
authors.initials: HG
authors.lastname: Feran
authors.forename: Tugrul
authors.initials: T
authors.lastname: Tansug
authors.forename: Mustafa
authors.initials: M
authors.lastname: Minoglu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D019072:Antibiotic Prophylaxis / Q000379:methods; D016025:Bone Transplantation / Q000379:methods; D003646:Debridement / Q000379:methods; D015299:Discitis / Q000382:microbiology / Q000601:surgery*; D017586:Diskectomy / Q000379:methods; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae; D014399:Tuberculosis, Spinal / Q000382:microbiology / Q000601:surgery*