Application of titanium and polyetheretherketone cages in the treatment of pyogenic spondylodiscitis

Schomacher, Markus; Finger, Tobias; Koeppen, Daniel; Süss, Olaf; Vajkoczy, Peter; Kroppenstedt, Stefan; Čabraja, Mario

doi:10.1016/j.clineuro.2014.09.027

Cited by 54 publications

(53 citation statements)

References 44 publications

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“…Poly-ether-ether-ketone (PEEK) cages as biocompatible alternatives to titanium implants have been used in spinal fusion surgery, but still have been an issue of debate in pyogenic spondylodiscitis. Recent published data could show favorable results on the application of PEEK cages, but prospective randomized controlled trials are lacking [20,21].…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive spine surgery in lumbar spondylodiscitis: a retrospective single-center analysis of 67 cases

et al. 2017

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Background Minimally invasive surgical techniques have been developed to minimize tissue damage, reduce narcotic requirements, decrease blood loss, and, therefore, potentially avoid prolonged immobilization. Thus, the purpose of the present retrospective study was to assess the safety and efficacy of a minimally invasive posterior approach with transforaminal lumbar interbody debridement and fusion plus pedicle screw fixation in lumbar spondylodiscitis in comparison to an open surgical approach. Furthermore, treatment decisions based on the patients preoperative condition were analyzed. Methods 67 patients with lumbar spondylodiscitis treated at our department were included in this retrospective analysis. The patients were categorized into two groups based on the surgical procedure: group (MIS) minimally invasive lumbar spinal fusion (n = 19); group (OPEN) open lumbar spinal fusion (n = 48). Evaluation included radiological parameters on magnetic resonance imaging (MRI), laboratory values, and clinical outcome. Results Preoperative MRI showed higher rates of paraspinal abscess (35.5 vs. 5.6%; p = 0.016) and multilocular location in the OPEN group (20 vs. 0%, p = 0.014). Overall pain at discharge was less in the MIS group: NRS 2.4 ± 1 vs. NRS 1.6 ± 1 (p = 0.036). The duration of hospital stay was longer in the OPEN than the MIS group (19.1 ± 12 days vs. 13.7 ± 5 days, p = 0.018). Conclusion The open technique is effective in all varieties of spondylodiscitis inclusive in epidural abscess formation. MIS can be applied safely and effectively as well in selected cases, even with epidural abscess.

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Section: Discussionmentioning

confidence: 99%

Minimally invasive spine surgery in lumbar spondylodiscitis: a retrospective single-center analysis of 67 cases

et al. 2017

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“…Schomacher et al compared Polyetheretherketone (PEEK) cages with titanium (TTN) cages [41]. No differences between the two cage types were found [41]. The differences between iliac bone struts and titanium mesh cages were analyzed by Yong et al [42].…”

Section: Outcomes Of Surgical Treatmentmentioning

confidence: 99%

“…No differences were found between the two study groups [18]. Two studies retrospectively compared the effectiveness of anterior fusion with different types of cages and cage versus strut graft [41,42]. Schomacher et al compared Polyetheretherketone (PEEK) cages with titanium (TTN) cages [41].…”

Section: Outcomes Of Surgical Treatmentmentioning

confidence: 99%

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Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

et al. 2015

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Background Spondylodiscitis is a spinal infection affecting primarily the intervertebral disk and the adjacent vertebral bodies. Currently many aspects of the treatment of pyogenic spondylodiscitis are still a matter of debate. Purpose The aim of this study was to review the currently available literature systematically to determine the outcome of patients with pyogenic spondylodiscitis for conservative and surgical treatment strategies. Methods A systematic electronic search of MEDLINE, EMBASE, Cochrane Collaboration, and Web of Science regarding the treatment of pyogenic spondylodiscitis was performed. Included articles were assessed on risk of bias according the Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence and strength of recommendation was evaluated according the GRADE approach. Results 25 studies were included. Five studies had a high or moderate quality of evidence. One RCT suggest that 6 weeks of antibiotic treatment of pyogenic spondylodiscitis results in a similar outcome when compared to longer treatment duration. However, microorganism-specific studies suggest that at least 8 weeks of treatment is required for S. aureus and 8 weeks of Daptomycin for MRSA. The articles that described the outcome of surgical treatment strategies show that a large variety of surgical techniques can successfully treat spondylodiscitis. No additional long-term beneficial effect of surgical treatment could be shown in the studies comparing surgical versus antibiotic only treatment. Conclusion There is a strong level of recommendation for 6 weeks of antibiotic treatment in pyogenic spondylodiscitis although this has only been shown by one recent RCT. If surgical treatment is indicated, it has been suggested by two prospective studies with strong level of recommendation that an isolated anterior approach could result in a better clinical outcome.

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“…Schomacher et al have compared the results of treatment of pyogenic spondylodiscitis with titanium or PEEK cages in addition to 3 month antibiotic therapy and found no reinfection in either group (17). However, a cage subsidence was observed in 70.3 % of all cases.…”

Section: Discussionmentioning

confidence: 99%

The use of porous tantalum cages in the treatment of unremitting spondylodiscitis: a case report

Fokter

Rečnik

2018

SlovMedJour

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Application of titanium and polyetheretherketone cages in the treatment of pyogenic spondylodiscitis

Cited by 54 publications

References 44 publications

Minimally invasive spine surgery in lumbar spondylodiscitis: a retrospective single-center analysis of 67 cases

Minimally invasive spine surgery in lumbar spondylodiscitis: a retrospective single-center analysis of 67 cases

Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

The use of porous tantalum cages in the treatment of unremitting spondylodiscitis: a case report

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