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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

PEEK cages in the treatment of pyogenic spinal infections – a report of 15 cases

Meeting Abstract

  • Christian Herbold - Klinik für Neurochirurgie Klinikum der Friedrich Schiller Universität, Jena, Germany
  • Jan Walter - Klinik für Neurochirurgie Klinikum der Friedrich Schiller Universität, Jena, Germany
  • Susanne Kuhn - Klinik für Neurochirurgie Klinikum der Friedrich Schiller Universität, Jena, Germany
  • Rupert Reichart - Klinik für Neurochirurgie Klinikum der Friedrich Schiller Universität, Jena, Germany
  • Rolf Kalff - Klinik für Neurochirurgie Klinikum der Friedrich Schiller Universität, Jena, Germany
  • Christian Ewald - Klinik für Neurochirurgie Klinikum der Friedrich Schiller Universität, Jena, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1685

DOI: 10.3205/10dgnc156, URN: urn:nbn:de:0183-10dgnc1569

Published: September 16, 2010

© 2010 Herbold et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Despite improved diagnostic methods aggressive therapeutic strategies in cases with spondylodiscitis remains possible life threatening problem. The “gold standard” surgical procedure combines local debridement, bone strut or titanium implant insertion combined with ventral or dorsal instrumentation. For unknown reasons PEEK cages, very popular in degenerative spine surgery, are still uncommon as an alternative spacer in the treatment of pyogenic vertebral infections.

Methods: We retrospectively analysed the data of 15 patients suffering from different neurological deficits caused by pyogenic cervical (n=6) or lumbal spondylodiscitis (n=9). In the cervical spine the infection was limited to the disc without relevant bony destruction of the adjacent endplates and without instability on preoperative flexion – extension films. These patients were treated with debridement of the infected disc and a PEEK Cage as intervertebral spacer alone. The patients suffering from a lumbar discitis were treated with an additional dorsal instrumentation.

Results: Staphylococcus species were the most frequent triggering germ (n=14). All patient were treated postoperatively with antibiotics according to the micobiological data. The postoperative follow-up was performed in our outpatient department including regular clinical MRI, CT and laboratory examinations at every presentation. Bony fusion on CT and complete regression of the inflammatory changes on MRI was achieved after seven to eight months with only moderate changes of the vertebral alignement and average cage subsidence of 2 mm. The clinical symptoms improved in all patients.

Conclusions: This study shows for the first time the feasibility to implant PEEK cages also patients suffering from pyogenic spondylodiscitis. Especially in the cervical spine the surgical procedure is less complex and there are no problems from a donor site compared with iliac bone grafting.