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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Infection control after instrumentation for pyogenic spondylodiscitis of the thoracolumbar spine with and without discectomy

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  • Bawarjan Schatlo - Universitätsmedizin Göttingen, Klinik f. Neurochirurgie, Göttingen, Deutschland
  • Veit Rohde - Universitätsmedizin Göttingen, Klinik f. Neurochirurgie, Göttingen, Deutschland
  • Insa Janssen - Technische Universität München, Klinikum rechts der Isar, Klinik für Neurochirurgie, München, Deutschland
  • Awad Alaid - Universitätsmedizin Göttingen, Klinik f. Neurochirurgie, Göttingen, Deutschland
  • Bernhard Meyer - Technische Universität München, Klinikum rechts der Isar, Klinik für Neurochirurgie, München, Deutschland
  • Ehab Shiban - Technische Universität München, Klinikum rechts der Isar, Klinik für Neurochirurgie, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV217

doi: 10.3205/18dgnc221, urn:nbn:de:0183-18dgnc2214

Published: June 18, 2018

© 2018 Schatlo et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Surgery for pyogenic spondylodiscitis as an adjunct to antibiotic therapy is an established treatment. However, the technique and extent of surgical debridement remains a matter of debate. Some propagate discectomy in all cases. Others maintain that standalone instrumentation is sufficient.

Methods: We reviewed charts of 387 consecutive patients from two centers who underwent instrumentation for pyogenic spondylodiscitis with a minimum follow-up of one year.

In center A, surgery was performed routinely with immobilization of the fused segment and aggressive debridement, i.e. discectomy and an interbody procedure. In center B, surgical treatment consisted of posterior pedicle screw instrumentation only. The primary outcome measure was the need for surgical revision due to recurrent intraspinal infection.

Results: 387 patients were identified. Discectomy and interbody procedure (group A) was performed in 181 patients while 206 patients underwent instrumentation surgery for spondylodiscitis without intradiscal debridement (group B). Mean age was 67±12 years, and female to male ratio was 1:2 (34% vs. 66% respectively). Surgical revision due to recurrent intraspinal infection was necessary in 4 cases (1%), where groups A and B both had 2 cases each.

Conclusion: Overall, intraspinal relapse of surgically treated pyogenic discitis was low in our retrospective series. The choice of surgical technique was not associated with a significant difference regarding infection control.