Idiopathic pyogenic thoracic and lumbar spondylodiscitis: outcome of long segment fixation

Abstract

BackgroundSpondylodiscitis is an infection of the vertebral body extending to the intervertebral disc, and possibly the surrounding paraspinal structures.ObjectivesTo evaluate the clinical results of posterior long segment transpedicular screws fixation and decompression of the infected area for management of idiopathic pyogenic spondylodiscitis of the thoracic and lumbar spine.MethodsThis retrospective study included 14 patients with idiopathic active pyogenic spondylodiscitis of the lumber and thoracic spine between January 2017 and December 2021, with follow-up continuing until December 2022. All patients had posterior long-segment rigid fixation with infection decompression.ResultsAll patients after 6-month follow-up had achieved complete fusion. There was no evidence of postoperative wound infection, and no patient had a recurrence of infection at the lesion site during follow-up. Prior to surgery, the mean VAS score for back pain was 7.6 (range 6–9), however, after surgery, it fell to 1.3 (0–3), a statistically significant improvement (P < 0.001) during the last follow-up. According to the Kirkaldy-Willis criteria, the functional prognosis was excellent in 11 individuals, good in two, and fair in one.ConclusionsPosterior long-segment fixation in conjunction with decompression of the affected area effectively resolved bacterial spinal infection and restored neurological impairment.