Surgical treatment in cervical spondylodiscitis

Background: Cervical spondylodiscitis represents 3-6% of cases of vertebral osteomyelitis.However frequent complications with a negative impact on neurologic function and quality of life from this condition impose an uphill battle to the surgeon and prompt for early and accurate treatment decisions.Methods: We conducted a retrospective review of patients presenting at a Colombian university hospital with cervical spine spondylodiscitis between 2017 and 2020.Demographic characteristics, neurological status, imaging findings, comorbidities, white blood cell (WBC) count, C-reactive protein, microbiological isolation and postoperative complications were analyzed.Results: 7 patients were included, 5 were male and the average age was 60.7 years (95% CI 52.7-68.7).The most frequent complaint was cervical pain in 4 cases (57.1%).3 patients (42.8%) presented neurological impairment (ASIA C in two and D in one patient).4 patients (57.1%) exhibited a moderate or high risk according to the Brighton spondylodiscitis score.4 patients (57.1%) had epidural abscess.All patients received a 42-day regimen of antibiotics.All patients with neurological deficit were taken to surgery, at an average time of 50 hours (95% CI 14.8-85.2) and all received anterior cervical corpectomy with plate stabilization.On one patient an emergency hemilaminectomy and decompression was performed due to progressive neurological impairment.A pathogen was isolated in 6 patients and S. aureus was the most frequent (4/6).At the last follow up, no signs of infection or hardware failure was present in the surgical group.Conclusion: Surgical management of cervical spondylodiscitis should be carried out in a timely manner in high-risk patients to reduce the risk of progressive neurological impairment.Instrumented fusion was not associated with hardware failure or persistent infection in our cases. Craniocervical Junction Anomalies BRAIN AND SPINE

Abstract licence: CC BY-NC-ND

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.