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Z Orthop Unfall 2022; 160(06): 621-628
DOI: 10.1055/a-1527-7939
Review/Übersicht

Surgical Treatment Strategies for Pyogenic Spondylodiscitis of the Thoracolumbar Spine

Article in several languages: English | deutsch
Max J. Scheyerer 
1   Department of Orthopaedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
,
Christian Herren
2   Clinic for Trauma and Reconstructive Surgery, University Hospital Aachen, Germany
,
Christian Kühne
3   Trauma and Hand Surgery, Schön Clinic Hamburg-Eilbek, Germany
,
Jörg Neufang
4   Spinal Surgery, Professional Accidents Clinic Murnau, Germany
,
Philipp Pieroh
5   Clinic and Polyclinic for Orthopaedics, Trauma Surgery and Plastic Surgery, University of Leipzig Medical Faculty, Germany
,
Nicolas H. von der Höh
5   Clinic and Polyclinic for Orthopaedics, Trauma Surgery and Plastic Surgery, University of Leipzig Medical Faculty, Germany
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Abstract

Background Despite advances, the morbidity and mortality rates of patients with spondylodiscitis remains high, with an increasing incidence worldwide. Although conservative therapy has progressed, several cases require surgical intervention. However, the indication and opportunities for surgical treatment are still disputable.

Methods In a joint consensus, the members of the ‘Spondylodiscitis’ working group of the Spine Section of the German Society for Orthopaedics and Trauma Surgery considered current literature, particularly the newly published S2k guideline of the AWMF, and examined the surgical indications and treatment strategies for thoracolumbar spondylodiscitis.

Results Surgical intervention for spondylodiscitis is only required in a small percentage of patients. In studies comparing conservative and surgical therapies, most patients benefitted from surgery, regardless of the surgical technique selected. Presently, the standard procedure is a combined dorsoventral approach, in which a monolateral attempt should always be made. The choice of material (PEEK, titanium) for ventral support does not influence the clinical result.

Key words

spondylodiscitis - spondylitis - infection - conservative therapy - operative therapy


Publication History

Article published online:
30 August 2021

© 2021. Thieme. All rights reserved.

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