Affiliation:
1. Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
2. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
3. Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Abstract
Abstract
BACKGROUND
While recent data has demonstrated the utility of lumbar pedicle screws for the treatment of vertebral osteomyelitis, the data are limited for thoracic pedicle screws.
OBJECTIVE
To investigate the effectiveness of thoracic pedicle screws for the surgical treatment of vertebral osteomyelitis.
METHODS
A retrospective review of all operations performed by 2 spinal neurosurgeons from 1999 to 2012 yielded 30 cases of vertebral osteomyelitis that were treated with thoracic pedicle screws. Sixteen (53%) of which underwent combined anterior and posterior fusion and 14 patients (47%) underwent standalone posterior fusion. Postoperative records were analyzed for pertinent clinical, laboratory, and radiographic data.
RESULTS
Of the 30 patients, 21 were males (70%), 8 were females (27%), and 1 was transsexual (3%). The mean age was 47 yr (range 18-69). The most common organism cultured was Staphylococcus aureus in 12 cases (50%). The mean patient stay in the hospital was 12.4 d after surgery (range 5-38 d). The mean antibiotic duration after discharge was 8 wk (range 1-24 wk). Of the 25 patients with long-term follow-up (mean, 49 mo), 92% had improved back pain (6/25 marked improvement, 17/25 complete resolution), 83% had improved muscle weakness (8/18 marked improvement, 7/18 complete resolution), and 100% had improved urinary incontinence (3/8 marked improvement, 5/8 complete resolution). Two patients (7%) required additional surgical revision due to instrumentation failure or wound infection.
CONCLUSION
This study demonstrates the efficacy of utilizing thoracic pedicle screws as a primary intervention to treat vertebral osteomyelitis.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Neurology (clinical),Surgery
Cited by
2 articles.
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1. Osteomyelitis;Treatment of Spine Disease in the Elderly;2023
2. Transpedicular fixation for hematogenous pyogenic vertebral osteomyelitis;Hirurgiâ pozvonočnika (Spine Surgery);2020-06-17