Cervical spondylodiscitis--a clinical analysis of surgically treated patients and review of the literature

Clin Neurol Neurosurg. 2014 Feb:117:86-92. doi: 10.1016/j.clineuro.2013.11.029. Epub 2013 Dec 7.

Abstract

Objective: The aim of this study was to analyze our clinical and neurological results of surgically treated patients suffering from cervical spondylodiscitis with focusing particularly on the surgical methods used and to review the literature.

Patients and methods: We present a series of 21 patients operated with cervical spondylodiscitis between 1998 and 2011. Basic demographic data, comorbidities, the radiological segments involved, the surgical strategy with special consideration of the material used and the clinical outcome were evaluated retrospectively.

Results: The mean age of 6 female and 12 male patients was 65 years (range 28-89 years). The mean follow-up was 3.7 years ranging between 4 weeks and 9 years. The leading symptom was neurological deficits rather than pain. The segments C 5/6 (n=8) and C 6/7 (n=7) were most frequently involved. Different surgical methods depending on the location, anatomical and pathological condition and extension of the lesion were performed.

Conclusion: In conclusion, cervical spondylodiscitis could effectively be treated in the presented patient cohort by surgical decompression, debridement and PMMA or bone graft implants followed by long term antibiotic therapy. The presented surgical reconstruction technique with PMMA might be a feasible alternative to the use of bone graft or cages. The promising clinical results warrant future prospective studies to further investigate this technique.

Keywords: Cervical spine; Spinal infection; Spine fusion; Spondylodiscitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bone Cements
  • Cervical Vertebrae / pathology
  • Cervical Vertebrae / surgery*
  • Contrast Media
  • Decompression, Surgical / methods
  • Discitis / microbiology
  • Discitis / pathology
  • Discitis / surgery*
  • Female
  • Follow-Up Studies
  • Gadolinium DTPA
  • Humans
  • Internal Fixators
  • Laminectomy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / methods*
  • Polymethyl Methacrylate
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Bone Cements
  • Contrast Media
  • Polymethyl Methacrylate
  • Gadolinium DTPA