Review article
Surgical treatment of spondylodiscitis
Zvonko Kejla
; KBC "Sr. milosrdnice", Klinika za traumatologiju, Zagreb, Hrvatska
Vide Bilić
; KBC "Sr. milosrdnice", Klinika za traumatologiju, Zagreb, Hrvatska
Tihomir Banić
; KBC "Sr. milosrdnice", Klinika za traumatologiju, Zagreb, Hrvatska
Nenad Somun
; KBC "Sr. milosrdnice", Klinika za traumatologiju, Zagreb, Hrvatska
Ivan Coc
; KBC "Sr. milosrdnice", Klinika za traumatologiju, Zagreb, Hrvatska
Abstract
In most cases spondylodiscitis can be treated conservatively, though complicated cases with pending or already existent neurological deficit, focal instability or deformity of the spine with acute pain have to be treated by surgical correction and instrumentation. Surgery is absolutely indicated in cases with epidural abscess formation and in cases in which conservative treatment have given no success. Goals of surgical treatment of spondylodiscitis are debridement of necrotic and infected tissues, decompression of neural structures, obtaining specimens for bacteriological and pathohystological diagnostics, and obtainment of spine stability, making possible early mobilization of the patient. Anterior, posterior or combined approaches can be utilized, being performed in single stage of staged procedure. Leading facts determining surgeon's tactics being localisation of inflammatory process and individual approach to the patient. Stability of the spine is achived by transpedicular fixation by screws and longitudinal rods, and by reconstruction of anterior column by means of cancellous bone filled titanium cages or by autologous structural bone grafting. In cervical spine surgical stability is achieved by anterior locking plates, and/or by posterior screw and rod system instrumentation. Benefit given by stabilized spine outpaces the risk of implanting metal implants in potentially contaminated area.
Keywords
Vertebral osteomyelitis; spondylodiscitis; surgical treatment
Hrčak ID:
133450
URI
Publication date:
31.3.2014.
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