Pyogenic vertebral osteomyelitis/disc infection

Titanium cages in the surgical treatment of severe vertebral osteomyelitis

“…Both the present study and studies by other authors have demonstrated that the use of metallic implants in an infected area of the spine does not lead to persistence or recurrence of the infection [4,8,19,21]. In addition to stabilisation of the spine, the good perfusion of the vertebral bodies and adequate soft tissue coverage of the anterior thoracolumbar spine (including immunologically active structures such as the peritoneum) are regarded as the main factors contributing to the success of this technique [4,12]. However, prior to cage insertion, a thorough surgical debridement of all infected and necrotic tissue is mandatory and appropriate antimicrobial therapy must be administered.…”

Anterior Interbody Grafting and Instrumentation for Advanced Spondylodiscitis

“…There are some controversies on operative or conservative treatment of spondylodiscitis despite modern medical management with antibiotics 13,18,20) . Conservative medical management in these patients is usually accompanied by a long period of immobilization as well as incomplete bony fusion.…”

Diagnostic Performance of Pyogenic Vertebral Osteomyelitis

“…Its incidence was estimated to be 1 : 250,000 (1) in one series and 1 : 450,000 in another series (2). However, the overall incidence has increased in recent years because there have been 1) an increased incidence of nosocomial bacteremia from intravascular devices, 2) an aging population, and 3) an increased prevalence of injection drug use (3)(4)(5)(6).…”

“…In one large study, risk factors for mortality and residual symptoms include neurological compromise at the time of diagnosis, nosocomial infection, and delayed diagnosis (11). Although there has been technological progress in diagnostic imaging, especially the advent of MRI (5,14), diagnosis of vertebral osteomyelitis is frequently delayed (3,(8)(9)(10)(11)13).…”