CORset Versus OstéoSynthese in Adult Pyogenic Spondylodiscitis

Launched by UNIVERSITY HOSPITAL, STRASBOURG, FRANCE · May 11, 2018

Keywords

ClinConnect Summary

Safety and efficacy of percutaneous for the indication of pyogenic spondylitis has been demonstrated retrospectively on small cohort studies, which is in line with our clinical experience. Although this therapeutic concept seems applicable to patients with spondylitis, the theoretical clinical benefit of minimally invasive surgery remains hypothetic and unclear compared to brace treatment, which might still be regarded as the gold standard.

Gender

ALL

Eligibility criteria

• Inclusion criteria:
• • adult patients presenting acute pyogenic spondylitis of the thoracolumbar spine
• • back pain at a minimum of 4 out of 10 on VAS
• • Diagnostic MRI and disc puncture + microbiological analysis required for antibiotic treatment and/or blood culture
• • Vertebral body involvement (osteolysis) \< 50% of VB height documented on CT
• Exclusion criteria:
• • postoperative pyogenic spondylitis or infection after spinal instrumentation spinal tuberculosis and mycosis
• • contra-indications for surgery or general anaesthesia
• • general septic conditions acute endocarditis documented by sonography
• • patients presenting another major abcess or an epidural abscess
• • Absence of vertebral body involvement (osteolysis) on CT or minor VB involvement less than 10% of VB height (surgery not indicated)
• • Major destruction of vertebral body (\>50%) on CT (surgery mandatory) Patients with concomitant bacterial endocarditis