Advances & More News / Reported from China: Early surgery with antibiotic medication was effective and efficient in treating pyogenic spondylodiscitis

Pyogenic spondylodiscitis (PSD) is considered a challenging condition for the orthopedist at the level of diagnosis and treatment. Therefore, researchers from Chancheng Central Hospital, Foshan, China, conducted a study to determine the most indicative diagnostic method and assess the surgery effect comprising debridement, instrumentation, and fusion in PSD treatment. In the study, 76 patients with PSD who did surgical intervention were enrolled retrospectively. Investigators assessed participants' medical documents, spinal alignment corrections, and improvements in neurological function. They also compared surgical approaches in lumbar surgeries concerning the advances in lordotic angle and neurological function. Outcomes show high C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in 77.6 and 71.1% of patients. In addition, research indicates that infectious lesions were noted in lumbar (85.5%), cervical (10.5%), and thoracic (3.9%), ascertained with contrast-enhanced MRI. Regarding lumbar patients, surgery was done through the anterior (26.2%), posterior (49.2%), or combined approach (24.6%), and the differences in improvement of lordosis and neurological function among each approach were insignificant. Investigators noted the pathogen in 22.4% of the patients and managed postoperative antibiotic therapy against the susceptibility test outcomes or given empirically to patients having negative cultures. Antibiotic treatment was initiated intravenously for 4–6 weeks and orally for six weeks. High CRP and ESR, with focal hyper-intensity on contrast-enhanced MRI, indicate possible PSD. In conclusion, research shows that surgical intervention encompassing debridement, short-segment instrumentation, and fusion that early applied to PSD patients followed by postoperative antibiotic therapy revealed preferable outcomes but needs further study. By: Advances and More Medical Reporters Reference: Guo, W., Wang, M., Chen, G. et al. Early surgery with antibiotic medication was effective and efficient in treating pyogenic spondylodiscitis. BMC Musculoskelet Disord 22, 288 (2021).
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