Spondylodiscitis: Understanding pathophysiology, surgical strategies, and postoperative management – A single-center study

Author:

Encarnación-Santos Daniel1,Valerievich Kim-A2,Scalia Gianluca3,Shestov Eugeny2,Pachev Murat2,Wellington Jack4,Bozkurt Ismail56,Rubenovich-Chikara Dmitriy2,Kirilin Igor2,Chmutin Gennady1,Tapia Ariel7,Ekhsan Naim2,Chaurasia Bipin8

Affiliation:

1. Department of Neurosurgery, People of Friendship University RUDN, Moscow, Russia

2. Deparment of Neurosurgery, City Clinical Hospital № 68 Gbuz Gkb Im. V.P. Demikhova, Moscow, Russia

3. Department of Head and Neck Surgery, Neurosurgery Unit, Garibaldi, Hospital, Catania, Italy

4. London School of Hygiene and Tropical Medicine, Branford Teaching Hospitals NHS Foundation Trust, Bradford, UK

5. Department of Neurosurgery, Medical Park Ankara Hospital, Ankara, Turkey

6. Department of Neurosurgery, School of Medicine, Yuksek Ihtisas University, Ankara, Turkey

7. Deparment of Orthopedic, Hospital Dr. Dario Contreras Santo Domingo, Santo Domingo Este, Dominican Republic

8. Department of Neurosurgery, Bhawani Hospital and Research Center, Birgunj, Nepal

Abstract

ABSTRACT Background: Spondylodiscitis (SD) is an inflammatory condition affecting the intervertebral discs and adjacent structures, often leading to serious complications, including epidural abscesses. This study aimed to differentiate postoperative SD from spontaneous cases caused by osteoporotic defects and associated pathologies, evaluating the frequency of SD in spinal diseases at a single center. Materials and Methods: A retrospective observational study involving 25 patients was conducted, analyzing variations between postoperative revisions in SD patients and spontaneous SD due to concurrent pathology and osteoporotic defects. The effects of postoperative wound healing following transforaminal lumbar interbody fusion and decompressive hemilaminectomy with pedicle screws were also investigated. Ethical guidelines were strictly followed during the study, conducted from January 2023 to September 2023 at Moscow City Clinical Hospital No. 68, Demikhova V.P. Results: Among the 25 patients with spontaneous SD, 15 females and 10 males were included, with only two undergoing surgical revision. Predominant purulent inflammatory foci were observed at specific spinal levels, and demographics revealed prevalent comorbidities such as arterial hypertension (80%) and type 2 diabetes mellitus (60%). Postoperative complications included paravertebral abscesses and wound-related issues. Structural observations indicated vertebral destruction, joint gaps, and localized spinal canal narrowing, revealing complexities in SD cases. Conclusion: Surgical intervention remains crucial for addressing SD-related vertebral complications, while antimicrobial therapy tailored to specific pathogens is pivotal. Concurrent conditions necessitate comprehensive management, often involving cardiological interventions. Postoperatively, a combined approach of conservative therapy and calcium phosphate adjuncts is recommended, especially considering the observed low bone density, aiming to optimize patient recovery and spinal stability.

Publisher

Medknow

Reference10 articles.

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4. Spondylodiscitis:Update on diagnosis and management;Gouliouris;J Antimicrob Chemother,2010

5. SponDT (spondylodiscitis diagnosis and treatment):Spondylodiscitis scoring system;Homagk;J Orthop Surg Res,2019

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