Aim of the study was to define the role of surgical stabilization of the spine in treatment of pyogenic spondylitis/diskitis.

We restrospectively analyzed patients referred to our department for treatment of pyogenic infection of axial skeleton.

In three years period we treated 51 patients with pyogenic infection of axial skeleton, and 46 of them were surgically stabilized by means of posterior instrumentation with or without anterior column reconstruction. Reoperation rate was 7%, and was in all cases associated with failure in reconstruction of anterior column of the spine. This could be achieved either by posterior or by combined approach, and there was no significant difference in perioperative complications in either group of patients. 14 patients presented with initial neurological deficit, and that presented the indication for urgent surgical procedure.

We conclude that surgical stabilization of axial skeleton should be always performed in patients with destruction of bone structure. The procedure allows easy achievement of material for bacteriological culture, and precisely targeted antibiotic treatment, and at the same time results with a stable spine, therefore allowing early rehabilitation of these patients. Though neurological deficit presents the indication for urgent decompression of neural structures, we emphasize the importance of reconstruction of all three columns of the spine in all circumstances.