J Korean Soc Spine Surg.  2001 Mar;8(1):39-45.

Posterior Lumbar Interbody Fusion in the Pyogenic Discitis

• Park WW
• Park YS
• Cheon SJ
• Jung JY

Abstract

STUDY DESIGN: To present preliminary results of PLIF (Posterior lumbar interbody fusion) and pedicle screw fixation in the lum-bar pyogenic discitis.
OBJECTIVES
To evaluate the advantages and effects of PLIF and posterior instrumentation over recurrence of infection in lum-bar pyogenic discitis which are resistant to antibiotics. SUMMARY OF LITERATURE REVIEW: To the date, anterior removal of the focus followed by interposing autogenous bone graft without additional instrumentation and postoperative long-term immobilization has been the standard operative procedure.
MATERIALS AND METHODS
10 consecutive patients who had lumbar pyogenic discitis were treated by posterior approach from October 1997 to March 1999.
RESULTS
Based on MRI or CT finding, 9 solid union at 3-4 months after operation and 1 suspicious union at 1 year after opera-tion were observed. The mean preoperative lordotic angle of the affected segments was 9 degree compared to 20 degree after postoperation and 17 degree at last follow up. As for functional result of Kirkaldy-Willis, outcome was excellent in 3, good in 5, fair in 2, none poor case. The duration of postoperative bed rest period was an average of 3 days.
CONCLUSIONS
PLIF with instrumentation in lumbar pyogenic discitis is a useful treatment in posterior epidural abscess,coexis-tent spinal stenosis and lower lumbar level where anterior fixation is impossible. It is especially indicated in the case of scanty antevertebral abscess with minimal bone destruction. Its main advantage is early ambulation.

Keyword

Lumbar spine; Discitis; Posterior lumbar interbody fusion

MeSH Terms

Abscess
Anti-Bacterial Agents
Bed Rest
Discitis*
Early Ambulation
Follow-Up Studies
Humans
Immobilization
Magnetic Resonance Imaging
Recurrence
Spinal Stenosis
Surgical Procedures, Operative
Transplants
Anti-Bacterial Agents

Figure

• 

  Fig. 1-A. Lateral radiographs shows L5-S1 disc space narrowing and irregular end plates. Fig. 1-B. T2-weighted image reveal a high intensity epidural abscess and destruction of the end plate. Als note the increased signal intensity in the involved surrounding vertebral bodies. Fig. 1-C. Follow-up lateral radiography, made 1 year 9 months after the operation, reveal solid fusion. Fig. 1-D. The CT scan demonstrates fusion between L5 and S1.

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