AUTHOR(S): 

Ioan Cristian Stoica, George Viscopoleanu, Stefan Mogos, Georgiana Nedelea, Bogdan Sendrea, Alexandru Draghici

TITLE

The Efficiency of a Posterior Approach Technique for the Management of Pyogenic Spondylitis

KEYWORDS

pyogenic spondylitis, posterior approach, stabilization, neurologic deficit, abscess, decompression, fusion

ABSTRACT

Pyogenic spondylitis is a severe infection of the spine which can be associated with debilitating neurologic deficits due to massive bone destruction and secondary collapse of the involved vertebral segments. If the symptoms are not severe, conservative management can be considered. When there is massive bone loss, neurologic deficits or severe pain, surgery is required. Although the most effective technique was considered to be anterior debridement associated with posterior stabilization, recent studies have shown good results with posterior only techniques. The objective of our study was to evaluate the efficiency of a posterior approach technique for the treatment of pyogenic spondylitis. We analyzed a group of 12 patients with confirmed pyogenic infection of the spine, which were operated through a posterior approach, with debridement, abscess evacuation and stabilization of the involved spine segments. There were 8 males and 4 females with a mean age of 60 (45-74) years. The most frequent involved pathogen was Methicillin-Sensitive Staphylococcus Aureus (MSSA), identified in 6 cases. Four patients had lumbar involvement and 8 had thoracic involvement. Two patients had neurologic deficit. All patients received post-operative antibiotic treatment in an infectious-disease hospital. The mean number of fused vertebrae was 4 (2-7). The mean operating time was 145 minutes (80-270) and the mean blood loss was 516 ml (250-1500). The minimum follow-up was 12 months. There were 2 reoperations: one for surgical site infection and one for instability of the involved segment which required anterior column reconstruction with a mesh cage, through an extended extracavitary posterior approach. A posterior approach technique for the treatment of pyogenic spondylitis is an effective technique for infection control and stabilization of the spine, without the extended operating times and risks associated with anterior surgery.

Cite this paper

Ioan Cristian Stoica, George Viscopoleanu, Stefan Mogos, Georgiana Nedelea, Bogdan Sendrea, Alexandru Draghici. (2017) The Efficiency of a Posterior Approach Technique for the Management of Pyogenic Spondylitis. International Journal of Medical Physiology, 2, 21-26