Anterior instrumentation for the treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine.

Abstract

Anterior radical debridement and bone grafting is popular in the treatment of pyogenic infection of the spine, but there remains great concern of placing instrumentation in the presence of infection because of the potentiality of infection recurrence after surgery. The objective of this study was to prospectively evaluate the efficacy and safety of anterior instrumentation in patients who underwent simultaneous anterior debridement and autogenous bone grafting for the treatment of pyogenic vertebral osteomyelitis. The series consisted of 22 consecutive patients who were treated with anterior debridement, interbody fusion with autogenous bone grafting and anterior instrumentation for pyogenic vertebral osteomyelitis of thoracic and lumbar spine. The patients were prospectively followed up for a minimum of 3 years (average 46.1 months; range 36-74 months). Data were obtained for assessing clinically the neurological function and pain and radiologically the spinal alignment and fusion progress as well as recurrence of the infection. All the patients experienced complete or significant relief of back pain with rapid improvement of neurological function. Kyphosis was improved with an average correction rate of 93.1% (range 84-100%). Solid fusion and healing of the infection was achieved in all the patients without any evidence of recurrent or residual infection. The study shows that combined with perioperative antibiotic regimen, anterior instrumentation is effective and safe in the treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine directly following radical debridement and autogenous bone grafting.

• Authors: Li-Yang Dai, Wei-Hua Chen, Lei-Sheng Jiang
• Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 17 Issue 8 Pg. 1027-34 (Aug 2008) ISSN: 1432-0932 [Electronic] Germany
• PMID: 18575900 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (therapeutic use)
• Bone Transplantation
• Debridement
• Female
• Humans
• Lumbar Vertebrae
• Male
• Middle Aged
• Orthopedic Fixation Devices
• Osteomyelitis (drug therapy, surgery)
• Spinal Fusion (instrumentation)
• Thoracic Vertebrae