Background:

Pyogenic spondylodiscitis (PSD) is a complex disorder that often required postoperative imaging. Carbon fiber reinforced PEEK (CFRP) is radiolucent and offers an optimal assessability of anatomical structures.

Methods:

A retrospective file review of patients who were operated on for PSD using CFRP-implants was performed to assess the clinical outcome, implant-associated complication, and revision surgery. A minimum follow-up of 3 months was required for evaluation of clinical and radiographical data which included CT and MRI assessment to determine implant stability and assessability of soft tissue and nerval structures using a grading system.

Results:

Eighty-one consecutive patients with a mean of 69.5 years were identified. Debridement and stabilization were performed in 8 cervical, 17 thoracic, and 57 lumbar procedures, 72 interbody fusion procedures using cages were performed. Intraoperatively no implant-associated complication was noted. The mean follow-up was 7 months at which 52 patients attended. Improved mobility and reduced pain levels were reported by 87%, and MRI assessability was graded ideal. Residual sign of infection was seen in five cases, which influenced antibiotic therapy. Asymptomatic radiolucent zones were identified in 13 (16%) and screw loosening in two (2.4%) patients. In one case the pedicle screw tip broke and remained within the vertebral body. Repeated procedure due to progressive vertebral body destruction, implant loosening, or subsidence was performed in five (6.1%) patients.

Conclusion:

The surgical treatment of PSD using CFRP is safe. The repeat procedure rate due to implant loosening is 6.1%. Minimal artifacts offer ideal assessability of soft tissue structures on an MRI.