Abstract
The role of spinal instrumentation in the presence of infection is still controversial, radical debridement of infected vertebrae and disc material may leave the spine unstable despite the use of bone graft, and some form of spinal stabilisation may deem necessary.
We reviewed 27 cases of primary pyogenic spinal infection treated in addition to an appropriate antimicrobial agents, by radical debridement, bone grafting and posterior (22) or anteror (5) spinal instrumentation.
The indication for surgery was the failure of conservative treatment (4), progressive neurological deficit (20) and the lack of diagnosis (3). The infection was caused by pyogenic bacteria (19), Mycobacterium Tuberculosis (6), Candida Albicans (1) Echinococcus granulosus (1).
The mean period of follow-up was 3.8 years (1–12). The infection was eradicated in all our patients, the neurological recovery was full in 19 out of 20 patients with neurological deficits.
Deep wound infection (Three immunocompromised patients, they all responded to repeated wound debridement); implant failure (Two patients, both required revision of fixation), early postoperative death due to nosocomial infection (1).
Spinal instrumentation may be indicated when after debridement and bone grafting, the stability of spine is compromised.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
