Single Stage Surgical Management of Primary Cervical Spondylodiscitis: Minimum 2 years results

Abstract

Background: Cervical Spondylodiscitis (CSD) is a serious medical condition that includes spondylitis, discitis, or both. Methods: We retrospectively evaluated 15 patients who were diagnosed with primary CSD and were managed between May 2018 and July 2021, by single-stage surgical procedure (debridement, anterior corpectomy, and plate fixation with titanium cage with autogenous bone graft) in Zagazig University Hospitals, Zagazig, Egypt. With a minimum of 2 years follow-up (mean 27.4 ±3.9) months, Assessments included preoperative criteria (risk factors, affected levels, symptoms, and signs) and postoperative radiologic and clinical outcomes; (Visual Analogue Scale) and ASIA (American Spinal Injury Association) . Results: CSD in all the patients was eradicated, and their infection lab tests normalized with no recurrence by the end of the follow-up period. The fusion was achieved in 14 out of 15 patients (93.3%) in (5.6 ± 2.3SD) months, implant failure and subsequent kyphotic deformity in one patient (6.6%) developed 6 months postoperative. The preoperative mean VAS (8.3 ± 0.88) decreased to a mean of (2.8 ±2) postoperatively, (P value < .001, degree of freedom DF=14). Neurological impairment was observed in 10 participants among whom 7 improved postoperatively (improvement rate was 70%). ASIA scale; improved in 7 patients (46.7%) (p=0.003, DF=14) Conclusion: Single Stage Surgical Management of primary Cervical Spondylodiscitis was successful in infection eradication with no recurrence, achieving a favorable fusion rate, realizing satisfactory VAS and ASIA results, with low overall complications. Level of evidence: IV retrospective study. Key Words: Cervical spondylodiscitis, Spinal infection, anterior corpectomy, cervical fixation, titanium cage