gms | German Medical Science

Objective: Spinal instrumentation is a treatment option for spontaneous spondylodiscitis in combination with antibiotic therapy. However, data on multilevel spondylodiscitis is scarce. This study evaluated potential differences in fusion rate after interbody fusion in combination with fixation for single-level and multi-level pyogenic spondylodiscitis.

Methods: Within a 10-year period in a single institution, a total of 151 patients underwent fusion und fixation of the spine for spontaneous spondylodiscitis. Surgical approaches were determined based on the location and length of spinal involvement, including single-level (n=102) and multi-level (n=49). Fusion rates were assessed at 3 months with computed tomography scans of the spine.

Results: The mean age was 65 years, (49 females, 102 males). 102 patients suffered from single- and 49 from multi-level spondylodiscitis. The most frequent location of discitis was the lumbar spine (n= 88; single n= 67, multiple n=21).

In 10 of the 49 patients with multi-level spondylodiscitis, the discitis was adjacent, and distant in 39 patients. Fusion rates did not differ within the multi-level group (discitis adjacent: 5 of 10 patients, 50% versus discitis distant 26 of 39 patients, 66%, p=0,456) after 3 months. In the mono-level group, the fusion rate was 72 of 102 patients (70%), there was no significance (p=0,465).

Conclusion: Surgical treatment option does not exhibit differences in fusion rates with regard to multi- and mono-level spondylodiscitis. Furthermore, our study demonstrated that within the multi-level subgroup, there is no difference of fusion state regarding adjacent and distant level of spondylodiscitis.