title: Posterior Only Approach for Lumbar Pyogenic Spondylitis With Short Instrumentation and Prolonged Suction Drainage.
abstract: METHODS
  A single-institution, single-surgeon retrospective review.
  
  
  OBJECTIVE
  To assess the efficacy of posterior only approach with short instrumentation and prolonged suction drainage in managing lumbar pyogenic spondylitis.
  
  
  BACKGROUND
  Several methods of posterior surgical treatment for pyogenic spondylitis have been reported, there have been few reports regarding the efficacy of posterior only approach with short instrumentation including even inflamed segment.
  
  
  METHODS
  Thirty-three patients with lumbar pyogenic spondylitis who underwent posterior decompression and lumbar interbody fusion with short instrumentation including the inflamed segment and catheter drainage were enrolled. Clinically infection control (erythrocyte sedimentation rate and C-reactive protein normalization time) and onset of ambulation were reviewed. Moreover, achievement of fusion and changes of sagittal alignment were investigated radiologically.
  
  
  RESULTS
  In all 33 cases, infection was controlled successfully without any recurrence. There was no breakage of implant. Postoperative interval to normalization of erythrocyte sedimentation rate was average 69.4 days and C-reactive protein was 25.4 days, respectively. Ambulation was started at average 5.8 postoperative days. Successful interbody fusion was confirmed radiologically in all the cases at a mean of 5.4 months. Sagittal angle of fixed segment was average 6.9 degrees of lordosis before operation, which became more lordotic to 11.5 degrees just after operation, but decreased to 4.7 degrees of lordosis at the final follow up. Actually final sagittal alignment was almost same as preoperative status (P = 0.24).
  
  
  CONCLUSIONS
  By achieving favorable clinical and radiological results, short instrumentation and prolonged suction drainage with posterior only approach seemed to be an effective method in managing lumbar pyogenic spondylitis.
  
  
  METHODS
  3.
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Yong-Min
authors.initials: YM
authors.lastname: Kim
authors.forename: Seung-Myung
authors.initials: SM
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008141:Lordosis / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods; D013396:Suction / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery*