Long-term results of surgical treatment for nonspecific vertebral osteomyelitis

Abstract

Objective. To assess surgical treatment techniques for treatment of patients with nonspecific vertebral osteomyelitis and their long-term results. Materials and Methods. A total of 125 patients with vertebral osteomyelitis were treated, out of them 49 (39.2 %) patients underwent major reconstructive surgery. Operative contraindications were multiple comorbidity, septic course of disease, or elderly age. All patient were treated with rational parenteral antibioticotherapy, detoxication therapy, extracorporal detoxication and immunomodulatory therapy according to the developed algorithm. Results. Long-term results were followed-up for 1 to 10 years after surgery. It was noted that in 1 year the graft remodeling mainly completed, in 2-3 years vertebral body sclerosis had a tendency to decrease, and trabecular bone structure became similar to that of the adjacent vertebrae. Restoration of supportive function of the spine (formation of a bone block at the level of surgery) was achieved in all patients. Conclusion. Timely minimally invasive surgery allows arresting inflammatory process, regression of neurologic symptoms, and restoration of supportive function of the spine in a majority of patients.