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Surgical Approach Algorithm in the Treatment of Lumbar and Thoracolumbar Pyogenic Spondylodiscitis
(TURKISH NEUROSURGICAL SOC, 2022-01-01) Akgul, Turgut; Bayram, Serkan; Korkmaz, Murat; Karalar, Sahin; Dikici, Fatih; Sar, Cuneyt
AIM: To reveal the efficiency of our surgical approach algorithm in patients with thoracolumbar pyogenic spondylodiscitis based on the involvement of anatomical structure. MATERIAL and METHODS: Data of patients who underwent debridement or stabilization surgery for thoracolumbar pyogenic spondylodiscitis from January 2012 to December 2018 were reviewed. Lumbar and thoracolumbar spondylodiscitis was classified into four stages based on anatomical involvement. Infection was limited in the disc space, which had not spread to the endplate in stage 1 and progressed as two-level corpus involvement of >1/2 of vertebral corpus bony destruction or as failed treatment in stage 4. Neurological function was evaluated using Frankel's grading postoperatively. Functional outcomes were categorized according to the Kirkaldy-Willis criteria. RESULTS: The study included 39 patients, with a mean age of 58.2 years. Of these patients, 10, 12, 13, and 4 had stages 1, 2, 3, and 4 spondylodiscitis, respectively. The mean follow-up period was 60.2 (12-184) months. All patients with stages 1 and 2 spondylodiscitis had grade E injury