Mootaz Shousha1, Heinrich Boehm. 1. Department of Spine Surgery and Paraplegiology, Zentralklinik Bad Berka, Bad Berka, Germany. mochoucha@hotmail.com
Abstract
STUDY DESIGN: A retrospective study of 30 consecutive cases of pyogenic cervical spine infection, excluding postoperative infections. OBJECTIVE: To establish a real incidence of the disease and the risk factors associated with its occurrence. Furthermore, to evaluate the different surgical approaches dealing with this condition as well as the complications associated with the disease itself and with the different lines of treatment undertaken. SUMMARY OF BACKGROUND DATA: Cervical spondylodiscitis is a quite rare finding regarding the common location of spinal abscesses in the lumbar and thoracic regions. METHODS: Between January 2004 and December 2009, 30 patients suffering from cervical spondylodiscitis underwent surgical debridement and reconstruction in our institution. The mean age at presentation was 64.5 years, and 19 patients were male (63.3%). Clinically, 24 patients (80%) had neck pain. Neurological deficit was found in 12 patients (40%), while septicemia was one of the presenting pictures in 12 patients (40%). Radiologically, epidural abscess was found in 24 patients (80%). Another concomitant noncontiguous discitis in the thoracic and/or lumbar spine was found in 14 patients (47%). All patients in this series underwent surgical debridement followed by antibiotic therapy for 8 to 12 weeks. Mean period of follow-up was 28.4 months. RESULTS: Healing of the inflammation was the rule. From the 12 patients with neurological deficit, 7 (58%) improved clinically after surgery. Three patients (10%) died postoperatively due to septicemia. Metal failure occurred in 1 patient in whom corpectomy, grafting, and ventral plating were performed. Esophagus perforation occurred in 1 patient with history of cancer pharynx and total neck dissection. CONCLUSION: Radical surgical debridement and appropriate antibiotic provide a reliable approach to achieve complete healing of the inflammation in cervical spondylodiscitis. Magnetic resonance imaging of the whole spine is recommended in all cases so as not to miss another infection in the spinal column. Regarding the surgical options, ventral plating after corpectomy for spondylodiscitis should be avoided.
STUDY DESIGN: A retrospective study of 30 consecutive cases of pyogenic cervical spine infection, excluding postoperative infections. OBJECTIVE: To establish a real incidence of the disease and the risk factors associated with its occurrence. Furthermore, to evaluate the different surgical approaches dealing with this condition as well as the complications associated with the disease itself and with the different lines of treatment undertaken. SUMMARY OF BACKGROUND DATA: Cervical spondylodiscitis is a quite rare finding regarding the common location of spinal abscesses in the lumbar and thoracic regions. METHODS: Between January 2004 and December 2009, 30 patients suffering from cervical spondylodiscitis underwent surgical debridement and reconstruction in our institution. The mean age at presentation was 64.5 years, and 19 patients were male (63.3%). Clinically, 24 patients (80%) had neck pain. Neurological deficit was found in 12 patients (40%), while septicemia was one of the presenting pictures in 12 patients (40%). Radiologically, epidural abscess was found in 24 patients (80%). Another concomitant noncontiguous discitis in the thoracic and/or lumbar spine was found in 14 patients (47%). All patients in this series underwent surgical debridement followed by antibiotic therapy for 8 to 12 weeks. Mean period of follow-up was 28.4 months. RESULTS: Healing of the inflammation was the rule. From the 12 patients with neurological deficit, 7 (58%) improved clinically after surgery. Three patients (10%) died postoperatively due to septicemia. Metal failure occurred in 1 patient in whom corpectomy, grafting, and ventral plating were performed. Esophagus perforation occurred in 1 patient with history of cancer pharynx and total neck dissection. CONCLUSION: Radical surgical debridement and appropriate antibiotic provide a reliable approach to achieve complete healing of the inflammation in cervical spondylodiscitis. Magnetic resonance imaging of the whole spine is recommended in all cases so as not to miss another infection in the spinal column. Regarding the surgical options, ventral plating after corpectomy for spondylodiscitis should be avoided.
Authors: Faris Shweikeh; Mohammed Hussain; Ajleeta Sangtani; Husam Issa; Asif Bashir; J Patrick Johnson; Georges Z Markarian Journal: Spinal Cord Ser Cases Date: 2017-07-06
Authors: George M Ghobrial; James S Harrop; Rick C Sasso; Chadi A Tannoury; Tony Tannoury; Zachary A Smith; Wellington K Hsu; Paul M Arnold; Michael G Fehlings; Thomas E Mroz; Anthony F De Giacomo; Bruce C Jobse; Ra'Kerry K Rahman; Sara E Thompson; K Daniel Riew Journal: Global Spine J Date: 2017-04-01