Minimally Invasive Spine Stabilization for Pyogenic Spondylodiscitis: A 23-Case Series and Review of Literature

June 28, 2022

Review

doi: 10.3390/medicina58060754.

Affiliations

¹ Department of Orthopaedic Surgery, Ota Memorial Hospital, Gunma 373-8585, Japan.
² Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita 286-0048, Japan.
³ Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Tokyo 108-8329, Japan.
⁴ Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Narita 286-8520, Japan.
⁵ Department of Orthopaedic Surgery, Kansai Medical University, Osaka 573-1191, Japan.

Free PMC article

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Review

Shinichi Ishihara et al.

Medicina (Kaunas).

2022.

Free PMC article

doi: 10.3390/medicina58060754.

Affiliations

¹ Department of Orthopaedic Surgery, Ota Memorial Hospital, Gunma 373-8585, Japan.
² Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita 286-0048, Japan.
³ Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Tokyo 108-8329, Japan.
⁴ Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Narita 286-8520, Japan.
⁵ Department of Orthopaedic Surgery, Kansai Medical University, Osaka 573-1191, Japan.

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Abstract

Background and Objectives: The incidence of pyogenic spondylodiscitis has been increasing due to the aging of the population. Although surgical treatment is performed for refractory pyogenic spondylodiscitis, surgical invasiveness should be considered. Recent minimally invasive spine stabilization (MISt) using percutaneous pedicle screw (PPS) can be a less invasive approach. The purpose of this study was to evaluate surgical results and clinical outcomes after MISt with PPS for pyogenic spondylodiscitis. Materials and Methods: Clinical data of patients who underwent MISt with PPS for pyogenic spondylitis were analyzed. Results: Twenty-three patients (18 male, 5 female, mean age 67.0 years) were retrospectively enrolled. The mean follow-up period was 15.9 months after surgery. The causative organism was identified in 16 cases (69.6%). A mean number of fixed vertebrae was 4.1, and the estimated blood loss was 145.0 mL. MISt with PPS was successfully performed in 19 of 23 patients (82.6%). Four cases (17.4%) required additional anterior debridement and autologous iliac bone graft placement. CRP levels had become negative at an average of 28.4 days after surgery. There was no major perioperative complication and no screw or rod breakages during follow-up. Conclusions: MISt with PPS would be a less invasive approach for pyogenic spondylodiscitis in elderly or immunocompromised patients.

Keywords:

minimally invasive spinal treatment (MIST); minimally invasive spine stabilization (MISt); minimally invasive spine surgery (MISS); percutaneous pedicle screw (PPS); pyogenic spondylodiscitis.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**

MRI and CT scan of case No. 14 at first admission. (a) X-ray of sagittal view; (b) Sagittal view of CT scan showed a destructive change of L3 and L4 vertebral bodies; and (c) T2-weighted sagittal view of MRI showed spondylodiscitis at L3-4 and L4-5 with epidural abscess.

**Figure 2**

X-ray and CT scan of case No. 14 immediately after surgery. (a) X-ray of AP view; (b) X-ray of lateral view; and (c) Axial views of CT scan showed accurate PPS placements.

**Figure 3**

Comparison of CT images before surgery and 12 months after surgery. (a,c) CT images before surgery showed destructive change of L3 and L4 vertebral bodies; (b,d) CT image at 12 months after surgery showed good bony union with callus bridging between L3 and L4.

References

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Minimally Invasive Spine Stabilization for Pyogenic Spondylodiscitis: A 23-Case Series and Review of Literature

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grant support

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Research Materials

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