Outcome Following Surgical Treatment of Pyogenic Spondylodiscitis
Chumpon Kakanan MD*, Luckchai Phonwijit MD*
Affiliation : * Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Pyogenic spondylodiscitis (PS) is a rare and life-threatening condition. Traditional treatment is surgical
debridement followed by antibiotic therapy.
Objective : To investigate risk factors, bacteriological features, treatment methods and clinical, laboratory, and radiological
findings and surgical outcomes in patients with PS.
Material and Method: Twenty-one patients who underwent treatment for PS at Siriraj Hospital during the January 2012 to
October 2015 study period were included. All patients received surgical debridement followed by antibiotic therapy.
Results : Five patients had complete cord PS. Infection was found in the following spinal regions: cervical (12), thoracic (2),
lumbar (4), and multiple regions (3). The most common presenting symptom was spinal pain. All patients had elevated ESR
and CRP. The most common isolated bacterium was Staphylococcus spp. Clinical improvement after surgical debridement
was observed in all patients, except in two who died because of other complications.
Conclusion : There should be a high index of clinical suspicion for PS in patients who have increased inflammatory markers
in the blood and local tenderness or pain in the spinal region. In cases with severe neurological deficit, surgical debridement
followed by antibiotic therapy is the most effective treatment.
Keywords : Pyogenic spondylodiscitis, Surgical debridement, Antibiotic therapy
