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Spondylodiscitis instrumented fusion, a prospective case series on a standardized neurosurgical protocol with long term follow up – Lumbar Fusion

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The article investigates the properties and outcomes of spondylodiscitis fusion, specifically examining fusion construct properties, construct length, intervertebral prosthesis (IVP) selection, bone grafting methods, complications management, and follow-up outcomes. The study was a case series conducted in a referral hospital, including surgery-eligible patients who underwent a neurosurgical intervention. The results showed that a neurosurgical protocol effectively achieved successful treatment, spine stabilization, and fusion with low long-term surgical complications. Autologous bone graft mixture had a higher fusion rate and lower mortality rate compared to titanium cages. Older age, neurological symptoms, and comorbidities were associated with less favorable clinical outcomes. Overall, the findings highlight the importance of a standardized neurosurgical approach for spondylodiscitis fusion

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised treatment facility in UK

Published article

: The introduced neurosurgical protocol could effectively achieve acceptable SD treatment, spine stabilization, and fusion with low long-term surgical complications. Autologous bone graft mixture in comparison to titanium cages showed a higher fusion rate with a lower mortality rate. Patients with older age, neurological symptoms, and comorbidities are expected to experience less favorable clinical outcomes.

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Injury. 2023 Oct 27:111164. doi: 10.1016/j.injury.2023.111164. Online ahead of print.ABSTRACTPURPOSE: To investigate the fusion construct properties, construct length, intervertebral prosthesis (IVP) selection, bone grafting methods, complications management, and follow-up outcomes of spondylodiscitis fusion.METHOD: This case series was conducted in Al-Zahra University referral hospital from March 2016 to November 2021. All the surgery-eligible patients were enrolled.,

Injury. 2023 Oct 27:111164. doi: 10.1016/j.injury.2023.111164. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the fusion construct properties, construct length, intervertebral prosthesis (IVP) selection, bone grafting methods, complications management, and follow-up outcomes of spondylodiscitis fusion.

METHOD: This case series was conducted in Al-Zahra University referral hospital from March 2016 to November 2021. All the surgery-eligible patients were enrolled. Those who did not participate or failed the neurosurgical intervention were excluded. A unified neurosurgical protocol was defined. After operation and follow-up, all variables were documented. IBM SPSS v.26 was used for data analysis. P-value ≤ 0.05 was considered significant.

RESULT: Ninety-two patients were reviewed in the final analysis with 65.2 % males. The mean age was 55.07 ± 14.22 years old. The most frequent level of pathology and surgery was the lumbar spine (48.9 %). Short and long constructs were almost equally used (57.6 and 42.4 %, respectively). Bone graft mixture was the dominant IVP (75 %). The most frequent persistent postoperative symptom was back pain (55.4 %), while the neurological deficits resolution rate was 76.7 %. The fusion rate was 92.3 %. Proximal junctional kyphosis incidence was 16.3 % and had a significant association with on-admission neurological symptoms, thoracic and thoracolumbar junction involvements (p < 0.05). Follow-up Oswestry disability index scores showed 44.6 % of the patients had mild or no functional disabilities. Advanced age, On-admission deficits, comorbidities, titanium cages, and poor fusion status were associated with poor functional outcomes and higher mortality rates (P < 0.05).

: The introduced neurosurgical protocol could effectively achieve acceptable SD treatment, spine stabilization, and fusion with low long-term surgical complications. Autologous bone graft mixture in comparison to titanium cages showed a higher fusion rate with a lower mortality rate. Patients with older age, neurological symptoms, and comorbidities are expected to experience less favorable clinical outcomes.

PMID:37923678 | DOI:10.1016/j.injury.2023.111164

The London Spine Unit : most specialised treatment facility in UK

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Spondylodiscitis instrumented fusion, a prospective case series on a standardized neurosurgical protocol with long term follow up

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Injury. 2023 Oct 27:111164. doi: 10.1016/j.injury.2023.111164. Online ahead of print.ABSTRACTPURPOSE: To investigate the fusion construct properties, construct length, intervertebral prosthesis (IVP) selection, bone grafting methods, complications management, and follow-up outcomes of spondylodiscitis fusion.METHOD: This case series was conducted in Al-Zahra University referral hospital from March 2016 to November 2021. All the surgery-eligible patients were enrolled.

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