Posterior Lumbar Interbody Fusion in the Pyogenic Discitis

Abstract

Study design : To present preliminary results of PLIF (Posterior lumbar interbody fusion) and pedicle screw fixation in the lumbar pyogenic discitis. Objectives : To evaluate the advantages and effects of PLIF and posterior instrumentation over recurrence of infection in lumbar pyogenic discitis which are resistant to antibiotics. Summary of Literature Review : To the date, anterior removal of the focus followed by interposing autogenous bone graft without additional instrumentation and postoperative long-term immobilization has been the standard operative procedure. Materials and Methods : 10 consecutive patients who had lumbar pyogenic discitis were treated by posterior approach from October 1997 to March 1999. Results : Based on MRI or CT finding, 9 solid union at 3~4 months after operation and 1 suspicious union at 1 year after operation were observed. The mean preoperative lordotic angle of the affected segments was 9°, compared to 20°after postoperation and 17°at last follow up. As for functional result of Kirkaldy-Willis, outcome was excellent in 3, good in 5, fair in 2, none poor case. The duration of postoperative bed rest period was an average of 3 days. Conclusions : PLIF with instrumentation in lumbar pyogenic discitis is a useful treatment in posterior epidural abscess,coexistent spinal stenosis and lower lumbar level where anterior fixation is impossible. It is especially indicated in the case of scanty antevertebral abscess with minimal bone destruction. Its main advantage is early ambulation.