gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Debridement and spinal instrumentation in pyogenic spondylitis

Débridement und instrumentierte Spondylodese bei eitriger Spondylitis

Meeting Abstract

Suche in Medline nach

  • corresponding author L. Weise - Neurochirurgische Klinik und Poliklinik, Charité, Berlin
  • M. Brock - Neurochirurgische Klinik und Poliklinik, Charité, Berlin
  • T. Kombos - Neurochirurgische Klinik und Poliklinik, Charité, Berlin

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-11.07

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0052.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Weise et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Controversy exists on the use of instrumentation in an infected site (e.g. pyogenic spondylitis). Recent Publications suggest that titanium implants can be safely used in infectious or contaminated sites in combination with debridement and antibiotic therapy. The aim of the study was to evaluate the clinical outcome of patients treated with surgical debridement and titanium instrumentation for pyogenic spondylitis.

Methods

Eighteen (18) patients (8 female, 10male) with pyogenic (n=14), tuberculotic (n=2) and post infectious (n=2) spondylitis were included in this study. The Cervical (n=4), thoracic (n=12) and lumbar (n=2) spine were affected. Every patient had a debridement followed by titanium instrumentation. The procedure was performed by an anterior or anterolateral (n=13), posterior (n=3) or combined anterior and posterior approach (n=2). The mean age at the time of surgery was 65y (range: 22 to 78). The majority of patients had risk factors, such as Diabetes, renal failure, infiltrations, trauma or prior surgery. Patients were evaluated before and after surgery in terms of pain level, neurologic status, Barthel index, radiologic and hematologic parameters. The mean follow-up period was 10 months (range: 3 to 25).

Results

There was an average decrease of 1-2 points in the Pain scale of Denis. Blood parameters showed significant decrease (mean Leukocyte count decreased from 11,4/nl to 7,1/nl and mean CRP levels dropped from 67mg/l to 9mg/l). Barthel index and sagittal angle in radiological evaluation were improved. Wound infection occurred in 3 patients. None of the instrumentations had to be removed.

Conclusions

This single stage approach for spondylitis provided satisfactory results also in patients with poor clinical condition and acute spondylitis.