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. 2006 Sep;15(9):1380-7.
doi: 10.1007/s00586-006-0191-z. Epub 2006 Jul 26.

Surgical treatment of spondylodiscitis in the cervical spine: a minimum 2-year follow-up

Christoph E Heyde  1 , Heinrich Boehm, Hesham El Saghir, Sven K Tschöke, Ralph Kayser
Affiliations

Surgical treatment of spondylodiscitis in the cervical spine: a minimum 2-year follow-up

Christoph E Heyde et al. Eur Spine J. 2006 Sep.

Abstract

Cervical spine spondylodiscitis is a rare, but serious manifestation of spinal infection. We present a retrospective study of 20 consecutive patients between 01/1994 and 12/1999 treated because of cervical spondylodiscitis. Mean age at the time of treatment was 59.7 (range 34-81) years, nine of them female. In all cases, diagnosis had been established with a delay. All patients in this series underwent surgery such as radical debridement, decompression if necessary, autologous bone grafting and instrumentation. Surgery was indicated if a neurological deficit, symptoms of sepsis, epidural abscess formation with consecutive stenosis, instability or severe deformity were present. Postoperative antibiotic therapy was carried out for 8-12 weeks. Follow-up examinations were performed a mean of 37 (range 24-63) months after surgery. Healing of the inflammation was confirmed in all cases by laboratory, clinical and radiological parameters. Spondylodesis was controlled radiologically and could be achieved in all cases. One case showed a 15 degrees kyphotic angle in the proximal adjacent segment. Spontaneous bony bridging of the proximal adjacent segment was observed in one patient. In the other cases the adjacent segments radiologically showed neither fusion nor infection related changes. Preoperative neurological deficits improved in all cases. Residual neurological deficits persisted in three of eight cases. The results indicate that spondylodiscitis in cervical spine should be treated early and aggressive to avoid local and systemic complications.

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Figures

Fig. 1
Fig. 1
Spondylodiscitis C5/6 with partial destruction of C5, kyphotic deformity and abscess, both paravertebral and epidural
Fig. 2
Fig. 2
Number and localisation of the segments of the cervical spine, involved in the infection process in case of spondylodiscitis (n = 20)
Fig. 3
Fig. 3
a Spondylodiscitis C5/6 with partial destruction of the C5 and C6 vertebra, MRI. b ap and lateral X-ray of the patient preoperatively c ap and lateral X-ray of the patient after operative treatment with a combined approach; complete bony fusion was achieved 6 months post operatively
Fig. 4
Fig. 4
a preoperative lateral X-ray and MRI of a patient with spondylodiscitis C5/6 with partial destruction of the vertebra C5 b lateral and ap X-ray 6 months postop. of the patient from a after combined surgery; complete bony fusion was achieved
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