| What is the Proper Management for Pyogenic Spondylodiscitis? Conservative? Surgery? |
|
James Ki Shinn1 , Seung Hwan Yoon1 , DoKeun Kim1 , Ji Yong Kim2 |
|
1Department of Neurosurgery, School of Medicine, Inha University, Incheon,
2Department of Neurosurgery, Naeun Hospital, Incheon, Korea |
|
|
| Abstract |
Objective
With population has been aging, infectious spondylodiscitis is being diagnosed with increasing frequency due to the increasing numbers of elderly patients, use of invasive spinal procedures. We discuss our experience on the management of infectious spondylodiscitis.
Methods
We reviewed the management, radiologic and clinical outcomes of 73 of pyogenic spondylitis patients treated between January 2008 and December 2012, and minimum follow up periods were 2 years. Patients were divided by conservative (group A) or surgical (group B) management. Surgery group and conservative treatment group in pyogenic spondylodiscitis were compared according to the clinical and radiologic profiles. Radiologic evaluation was assessed and
clinical outcome was evaluated with Visual Analogue Scale (VAS) for pain and Oswestry Disability Index (ODI) for disability. Also, hospital stay term and medical cost were included in this study.
Results
Mean age of patients was 67.1 of group A and 65.7 of group B, respectively. For early surgical management, 42 out of 73 patients (57.6%) were treated. Mean hospital stay was 32.7±4.6 days for group A and 21.3±3.7 days for group B, respectively. Medical costs of group B (2,235,000 Korean Won) was not more than that of group A (2,380,000 Korean Won). Radiologic outcome that of sagittal balance, local angle was different between two groups. Clinical outcomes including VAS and ODI were also different between two groups.
Conclusion
Surgical management such as debridement, decompression, restoration of spinal alignment, and correction of instability is considered for treatment options for failure of conservative therapy or severe pyogenic spondylodiscitis. |
| Key Words:
Pyogenic spondylodiscitis, Surgical management, Conservative management, Spine infection |
|
PDF Links
Download Citation
