There have been few reports regarding the efficacy of posterior instrumentation alone as surgical treatment for patients with pyogenic spondylitis, thus avoiding the morbidity of anterior surgery. We report the clinical outcomes of six patients with pyogenic spondylitis treated effectively with a single-stage posterior fusion without anterior debridement at a mean follow-up of 2.8 years (2 to 5). Haematological data, including white cell count and level of C-reactive protein, returned to normal in all patients at a mean of 8.2 weeks (7 to 9) after the posterior fusion. Rigid bony fusion between the infected vertebrae was observed in five patients at a mean of 6.3 months (4.5 to 8) post-operatively, with the remaining patient having partial union. Severe back pain was immediately reduced following surgery and the activities of daily living showed a marked improvement. Methicillin-resistant Staphylococcus aureus was detected as the causative organism in four patients.

Single-stage posterior fusion may be effective in patients with pyogenic spondylitis who have relatively minor bony destruction.

Objective: To investigate the clinical outcome of debridement arthroplasty using medial approach for the osteoarthritis of the elbows.

Methods: 40 elbows in 36 patients with osteoarthritis of the elbow were reviewed retrospectively. All of the patients were men and the mean age at the time of surgery was 60.0 years. The mean duration of follow-up was 35 months. All elbows were managed operatively with debridement arthroplasty. This procedure consisted of removal of free bodies, resection of inflammatory synovia, and resection of osteophytes. Medial approach with medial epicondylectomy was applied for all cases. In 10 elbows, posterior approach was used additionally for the debridement of posterior compartment.

Results: 23 elbows (57.5 %) had an excellent result, 11 elbows (27.5 %) had a good result, and six (15 %) had a fair result. 10 elbows (25%) had complete relief of pain while the other 30 elbows (75 %) had partial relief. Remaining pain was mostly located at the lateral aspect in patients with severe radiohumral arthritis. Flexion was improved from 106.5 degrees to 121.5 degrees.

Conclusion: This procedure is effective for patients with osteoarthritis of the elbow which is localized in ulnohumeral joint. Total elbow arthroplasty must be considered for the severe radiohumeral arthritis. Careful selection of patients is essential for successful outcome.