AI Article Synopsis
- The study aimed to demonstrate the effectiveness of a surgical algorithm for treating thoracolumbar pyogenic spondylodiscitis based on the extent of anatomical involvement.
- From January 2012 to December 2018, data was analyzed from 39 patients classified into four stages of spondylodiscitis, with surgical outcomes assessed postoperatively using Frankel's grading system and Kirkaldy-Willis criteria.
- Results showed that higher surgical stages correlated with lower functional outcomes, but stages 1 and 2 had excellent recovery rates, reinforcing the value of a staged approach in surgical decision-making.
Article Abstract
Aim: To reveal the efficiency of our surgical approach algorithm in patients with thoracolumbar pyogenic spondylodiscitis based on the involvement of anatomical structure.
Material And Methods: Data of patients who underwent debridement or stabilization surgery for thoracolumbar pyogenic spondylodiscitis from January 2012 to December 2018 were reviewed. Lumbar and thoracolumbar spondylodiscitis was classified into four stages based on anatomical involvement. Infection was limited in the disc space, which had not spread to the endplate in stage 1 and progressed as two-level corpus involvement of > 1/2 of vertebral corpus bony destruction or as failed treatment in stage 4. Neurological function was evaluated using Frankel's grading postoperatively. Functional outcomes were categorized according to the Kirkaldy-Willis criteria.
Results: The study included 39 patients, with a mean age of 58.2 years. Of these patients, 10, 12, 13, and 4 had stages 1, 2, 3, and 4 spondylodiscitis, respectively. The mean follow-up period was 60.2 (12-184) months. All patients with stages 1 and 2 spondylodiscitis had grade E injury; 2 and 10 patients with stage 3 had grades D and E injuries, respectively; two patients with stage 4 had grade D injury and two had grade E injury at the last follow-up. Moreover, 100%, 84.6%, and 50% of the patients with stages 1 and 2, 3, and 4 spondylodiscitis achieved good or excellent results, respectively.
Conclusion: The choice of the surgical technique depends on the destruction severity at the adjacent vertebral corpus. Surgical staging system for spondylodiscitis is useful and reliable in choosing appropriate surgical techniques.
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| http://dx.doi.org/10.5137/1019-5149.JTN.33784-21.2 | DOI Listing |
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