Treatment of Spontaneous Adult Thoracolumbar Spondylodiscitis With Interbody Fusion Using Autogenous Bone from Decorticated Spinous Process Supplanted with Posterolateral Transpedicular Rod-Screw Fixation, MAHMOUD M. WAHDAN, MOATAZ A. ELAWADY and AHMED M. DEABES
Abstract
Background: Spontaneous spondylodiscitis, although rare, but carries the risk of developing neurological impairment. Aim of Study: We aim at introducing our experience with the treatment of spontaneous adult spondylodiscitis with interbody fusion using autogenous bone from decorticated spinous process supplanted with posterolateral transpedicular rod-screw fixation at the Neurosurgery Department of Benha University Hospital between January 2015 and November 2019. Patients and Methods: Between January 2015 and No-vember 2019, among 51 patients who were diagnosed with pyogenic thoracolumbar spondylodiscitis, 12 patients (8 males and 4 females) underwent curettage, drainage and interbody fusion using autogenous bone from the removed spinous process augmented with transpedicular rod-screw fixation. Results: All patients, but one, showed improvement of their preoperative pain and the level of inflammatory markers in the blood. This patient was diagnosed as having screw pull-out and needed surgical reinsertion with a larger screw. Conclusions: Lumbar interbody fusion using autogenous bone from decorticated spinous process supplanted with posterolateral transpedicular rod-screw fixation represents a reasonable substitute to the traditional anterior curettage, stabilization with additional posterior rod-screw fixation for the treatment of spontaneous lumbar spondylodiscitis.