Treatment of infections of the lumbar spine with single-staged posterior instrumentation, disc debridement and interbody fusion with titanium cages

Abstract

Background. The goal of this study is to compare the clinical and radiological results of a single-staged posterior instrumentation, disc debridement and interbody fusion with titanium cages for patients with pyogenic infections of the lumbar spine and patients with degenerative disc disease. Methods. Posterior instrumentation, disc debridement and interbody fusion with titanium cages was performed on 35 patients affected by infections of the lumbar spine with compression of neural elements, neurological deficits or abscesses. At a minimum follow-up of one year, a functional and radiological evaluation was conducted, including a CT-scan of the operated segments to assess bony interbody fusion. A matched series of patients who underwent 360°-fusion with titanium interbody cages for the treatment of single-level degenerative disc disease was used as control group. Results. Twenty-eight patients were available for evaluation. The median VAS improved notably after intervention, as did the questionnaires investigating function, activities of daily living and quality of life. These changes were comparable to those observed in the control group. A similar proportion of patients rated the results of surgical intervention as good or excellent in both groups. Bony interbody fusion was observed in 87.5% of the patients. Conclusion. Posterior instrumentation, disc debridement and interbody fusion with titanium cages can effectively reduce pain and leads to an acceptable fusion rate. A substantial equivalence in terms of clinical results and subjective satisfaction is obtained in patients receiving this surgery for pyogenic infections with minimal anterior column disruption and for the treatment of degenerative disc disease.