Treatment of Pyogenic Vertebral Osteomyelitis With Anterior Debridement and Fusion Followed by Delayed Posterior Spinal Fusion

摘要: Study design Case series. Objectives The results of surgical treatment osteomyelitis with anterior debridement and fusion followed by delayed posterior stabilization are presented. Methods Forty-two patients vertebral There were 5 cervical, 12 thoracic, 1 thoracolumbar, 19 lumbar, lumbosacral lesions. most frequently identified organism was Staphylococcus aureus. Most had significant comorbidities, including diabetes, or immunocompromised. Ninety percent elevated erythrocyte sedimentation rates C-reactive proteins, while white blood cell counts less reliably elevated. Imaging studies included radiographs, CT scans, MRIs. All treated strut grafting 14.4 days intravenous antibiotics instrumented fusions received 6 weeks after surgery. Results resolution their infections no recurrence. two deaths. Neurologic deficits resolved in all patients. diagnosis pyogenic is presents a challenge. indications for neurologic compromise, failed medical treatment, soft tissue extension, extensive body disc space destruction, progressive deformity. Many these severely ill at presentation required urgent treatment. Anterior allows restoration column support control the infection before instrumentation fusion. Conclusion This study demonstrates that fusion, period highly effective has management.