Clinical outcomes of percutaneous curettage and continuous irrigation for pyogenic spondylitis

Abstract

Background Several recent studies have reported percutaneous curettage and continuous irrigation as effective treatments for pyogenic spondylitis. However, factors affecting the normalization of CRP levels remain unclear. This retrospective study investigated the clinical outcomes of percutaneous curettage and continuous irrigation for pyogenic spondylitis, and factors affecting the duration until normalization of CRP levels. Methods Subjects comprised 16 patients who underwent percutaneous curettage and continuous irrigation for pyogenic spondylitis. Patients were divided into 3 groups according to duration from surgery until normalization of CRP levels to ≤0.20 mg/dL: early (n = 5), ≤2 weeks; middle (n = 6), ≤6 weeks; and delayed (n = 5), >6 weeks. Clinical and radiographic findings were compared between groups. Results Japanese Orthopaedic Association score was improved in all patients within 2 weeks after surgery. Preoperative CRP level was lower in the early group (0.55 ± 0.27 mg/dL) compared with the middle (2.63 ± 1.84 mg/dL; P < .05) and delayed groups (7.59 ± 10.44; P < .05). Duration of irrigation was shorter in the delayed group (10.7 ± 3.7 days) compared with the early (15.6 ± 2.0 days; P < .05) and middle groups (15.5 ± 3.0 days; P < .05). Findings on MRI improved within 2 months in the early and middle groups. Conclusions This treatment is minimally invasive and useful in patients with pyogenic spondylitis. Lower CRP level before surgery and longer duration of irrigation may reduce the duration to normalization of CRP level.