POSTERIOR DEBRIDEMENT WITH TRANS-PEDICULAR SCREW FIXATION FOR IDIOPATHIC LUMBAR SPONDYLO-DISCITIS

Introduction: The treatment of vertebral osteomyelitis includes antibiotics with or without surgical intervention. Debridement is warranted for the treatment of idiopathic spondylo-discitis in case of neurological deficits, deformity, instability, abscess formation, intractable pain or failure of medical management. The use of instrumentation is still controversial. Objective: Was to evaluate the surgical outcome of idiopathic lumbar spondylodiscitis treated with posterior debridement combined with single-stage posterior instrumentation and autologus bone grafting. Methods: This retrospective study was conducted to evaluate the outcome of 15 cases of idiopathic lumbar spondylo-discitis treated with posterior debridement combined with single-stage posterior instrumentation and grafting. All patients were followed up for up to 1 year post-operative. We evaluated operative time, blood loss, and complications. Visual analogue scale (VAS), activities of daily living (ADL) (Barthel index), C reactive proteins (CRP), and Erythrocyte sedimentation rate (ESR) in the preoperative, postoperative and final follow-up periods were used to evaluate the surgical outcome. Results: All 15 cases of lumbar infections resolved without recurrence. Bony union was obtained in all cases. Twelve out of 15 patients (80%) were completely relieved of pain and fully active with improvement neurological deficits, while the other 3 patients (20%) obtained a good result. No post-operative major complications were reported among the studied group. There were two superficial infections, which healed with debridement and antibiotics. Conclusion: According to the results reported in this short study, the proposed technique is an effective and safe treatment for idiopathic lumbar spondylo-discitis, if surgery is mandatory.