Management of post operative lumbar spondylodiscitis

Document Type : Original Article

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Department of Neurology and Psychiatry, El-Minia Faculty of Medicine

Abstract

Introduction: Spondylodiscitis is a rare but serious infection of the intervertebral disc with possibly 
devastating outcome. The peak incidence is in patients under 20 years of age and between 50 and 70 
years of age. The incidence ranges from 0.4 - 2.5 per 100,000 per year. Spondylodiscitis occurs 
secondary to a variety of causes, most notably bloodstream infections (e.g. Staphylococcus aureus) 
and after surgery. Aim of the work: The aim of the work is to compare between conservative 
management versus fixation in treatment of post operative lumbar spondylodiscitis and prognosis of 
each one.. Patients and Methods: Forty cases with post operative lumbar spondylodiscitis admitted 
to Minia university hospital reviewed retrospectively. Twenty of them underwent surgical 
decompression with fixation and the other twenty were treated conservatively. Results: Group 1: 20 
patients (50%) for conservative management. Group 2: 20 (50%) patients underwent surgical fixation 
– 16 of them by screws only and 4 by screws and cage. Results according to Age & sex Table (1)
The age ranged between 37 years and 67 years with mean/SD (52.57±7.09). As regarding sex, 26 
patients were males (65%) and 14 were females (35%). Distribution of the studied cases according to 
demographic data (n= 40). Conclusion: Surgical management of post operative lumbar 
spondylodiscitis provides less rate of complications than conservative management. There is 
statistically significant difference between both method of management as regards of post operative 
complications, VAS score improvement, final clinical outcome (KWC) and post operative 
neurological status according to ASIA . So surgical fixation is recommended for management in post 
operative lumbar spondylodiscitis.

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