Debridement, Interbody Graft using Titanium Mesh Cage, Posterior Mono-Segmental Instrumentation and Fusion in the Surgical Treatment of Mono-Segmental Lumbar or Lumbosacral Pyogenic Vertebral Osteomyelitis via a Posterior- only.

November 24, 2019

OBJECTIVE:

The main objective of the present study was to analyse the efficacy and feasibility of surgical management for patients with mono-segmental lumbar or lumbosacral pyogenic vertebral osteomyelitis (PVO) by using one stage posterior debridement, interbody graft using titanium mesh cage, posterior mono-segmental instrumentation and fusion.

METHODS:

From February 2014 to May 2016, 27 cases with lumbar or lumbosacral PVO were treated by posterior debridement, interbody graft using titanium mesh cage, posterior mono-segmental instrumentation and fusion. The degree of damage to the patients’ vertebral bodies was 1/3-1/2 height. There were 16 male and 11 female with a mean age of 43.5 years (range: 32-56 years) at the time of surgery. The mean follow-up time was 35.7 months (range 26-53 months). The clinical efficacy was evaluated on average operation time, blood loss, visual analog scale (VAS), erythrocyte sedimentation rate (ESR), C-Reactive protein (CRP), neurological function recovery.

RESULTS:

PVO was completely cured and the grafted bone was fused in all 27 patients. There was no recurrent vertebral osteomyelitis infection. ESR, CRP got normal limits within 3 months in all patients.The ASIA neurological classification was improved in all cases. Pain relief was obtained in all patients.

CONCLUSIONS:

Our results showed that one stage posterior debridement, interbody graft using titanium mesh cage, posterior mono-segmental instrumentation and fusion was an effective treatment for patients with 1/3-1/2 height of vertebral body damaged in mono-segmental lumbar or lumbosacral PVO. It is characterized as minimum surgical trauma, good pain relief, good neurological recovery, good reconstruction of spinal stability.