Treatment of Thoracolumbar Pyogenic Spondylitis with Minimally Invasive Posterior Fixation without Anterior Lesion Debridement or Bone Grafting: A Multicenter Case Study

Hisanori Gamada, Toru Funayama, Akihiro Yamaji, Shun Okuwaki, Tomoyuki Asada, Shigeo Izawa, Hiroshi Kumagai, Kengo Fujii, Kuniaki Amano, Itsuo Shiina, Masaki Tatsumura, Masafumi Uesugi, Tsukasa Nakagawa, Masashi Yamazaki, Masao Koda

Research output: Contribution to journalArticlepeer-review

Abstract

The usefulness of minimally invasive posterior fixation without debridement and autogenous bone grafting remains unknown. This multicenter case series aimed to determine the clinical outcomes and limitations of this method for thoracolumbar pyogenic spondylitis. Patients with thoracolumbar pyogenic spondylitis treated with minimally invasive posterior fixation alone were retrospectively evaluated at nine affiliated hospitals since April 2016. The study included 31 patients (23 men and 8 women; mean age, 73.3 years). The clinical course of the patients and requirement of additional anterior surgery constituted the study outcomes. The postoperative numerical rating scale score for lower back pain was significantly smaller than the preoperative score (5.8 vs. 3.6, p = 0.0055). The preoperative local kyphosis angle was 6.7°, which was corrected to 0.1° after surgery and 3.7° at the final follow-up visit. Owing to failed infection control, three patients (9.6%) required additional anterior debridement and autogenous bone grafting. Thus, in this multicenter case series, a large proportion of patients with thoracolumbar pyogenic spondylitis could be treated with minimally invasive posterior fixation alone, thereby indicating it as a treatment option for pyogenic spondylitis.

Original languageEnglish
Article number932
JournalJournal of Clinical Medicine
Volume12
Issue number3
DOIs
StatePublished - Feb 2023
Externally publishedYes

Keywords

  • instrumentation
  • minimally invasive spine stabilization
  • posterior fixation
  • pyogenic spondylitis

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