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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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Long-term clinical and radiological outcome following surgical treatment of lumbar spondylodiscitis – a retrospective multicentre study

Klinische und radiologische Langzeitergebnisse nach chirurgischer Behandlung von lumbalen Spondylodiszitiden – eine retrospektive multizentrische Studie

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  • presenting/speaker Björn Sommer - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland; University Hopsital Erlangen, Department of Neurosurgery, Erlangen, Deutschland
  • Timo Babbe-Pekol - University Hopsital Erlangen, Department of Neurosurgery, Erlangen, Deutschland
  • Julian Feulner - University Hopsital Erlangen, Department of Neurosurgery, Erlangen, Deutschland
  • Richard Heinrich Richter - Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Department of Orthopedic Surgery, Erlangen, Deutschland
  • Michael Buchfelder - University Hopsital Erlangen, Department of Neurosurgery, Erlangen, Deutschland
  • Ehab Shiban - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland
  • Stefan Sesselmann - OTH Technical University of Applied Sciences Amberg-Weiden, Institute for Medical Engineering, Weiden, Deutschland
  • Raimund Forst - Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Department of Orthopedic Surgery, Erlangen, Deutschland
  • Kurt Wiendieck - University Hospital Erlangen, Department of Neurosurgery, Erlangen, Deutschland; Kliniken Dr. Erler Nürnberg, Department of Spine Surgery, Nürnberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV042

doi: 10.3205/21dgnc044, urn:nbn:de:0183-21dgnc0444

Published: June 4, 2021

© 2021 Sommer 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: Spinal instrumentation for spondylodiszitis remains highly controversial. To date surgical data is limited to relatively small case series with short term follow up data. In this study, we wanted to elucidate biomechanical, surgical and neurological long-term outcomes in these patients.

Methods: We retrospectively screened the databases of two German primary care hospitals and identified 190 patients with non-specific SD over a 9-year period (2005-2014). Inclusion criteria were a) non-specific, non-tuberculous lumbar SD, b) minimum follow-up 1 year, c) Following surgical instrumentation. Clinical and radiological outcome was assessed before surgery, at discharge and at a minimum of 12 months follow up.

Results: Complete data was available in 70 patients (49 male, 21 female, age 67.0±12.1 years) with a median follow-up of 6.6±4.2 years. Follow-up data was available in 70 patients after 1 year, in 58 patients after 2 years, and 44 patients after 6 years. 35 patients underwent posterior stabilization and decompression alone, 35 were operated in a two-stage 360° interbody fusion with decompression. Pre- and postoperative angles of the affected motion segment were 16±10.8 and 14±11.3° in patients with posterior instrumentation only, 19±9.6 and 16.9±9.7° in patients with combined anterior/posterior fusion. Vertebral body subsidence was seen in 12 (34.3%) and 6 (17.1%) cases following posterior instrumentation and 360° Instrumentation, respectively. Non-Fusion was encountered in 22 (62.9%) and 11 (31.4%) cases following posterior instrumentation and 360° instrumentation, respectively. Length of hospital stay was 35±24.8 days. Overall surgery-associated complication rate was 18% (12/70). New neurological symptoms occurred in 7% (5/70). Revision surgery was performed in 3% (2/70) due to screw misplacement/hardware failure and in 4% (3/70) due to intraspinal hematoma. During follow-up, there were no SD-related deaths.

Conclusion: Surgical treatment of spondylodiscitis with a staged surgical approach (if needed) is safe and provides excellent long term clinical and radiological outcome.