Outcome of Transforminal Lumbar Thorough Debridement, Decompression and Spondylodesis (TLTDDS) technique in Treatment of 25 patients with Pyogenic Spondylodiscitis.

Outcome of Transforminal Lumbar Thorough Debridement, Decompression and Spondylodesis (TLTDDS) technique in Treatment of 25 patients with Pyogenic Spondylodiscitis.

World Neurosurg. 2019 Jan 02;:

Authors: Omran K, Ibrahim AH

Abstract
BACKGROUND: Lumbar Pyogenic Spondylodiscitis (LPS) is still a tangled problem in its management especially after increasing rates of its incidence in cases underwent different spinal procedures and in patients with chronic medical disease. One stage posterior direct Transroforminal Lumbar Thorough Debridement of septic lesion, Decompression and Spondylodesis (TLTDDS) are the main goals in treatment of complicated LPS without additional morbidity of anterior surgery.
PURPOSE: Retrospective assessment of the clinical, laboratory, functional and radiological outcomes in 25 patients with LPS underwent TLTDDS procedure.
PATIENTS AND METHODS: Twenty nine patients with complicated LPS were treated surgically by TLTDDS surgery from January 2014 to August 2017. Complete records of 25 patients were available for evaluation. All patients were examined clinically back or leg pain using Visual Analog Scale (VAS) and neurological assessment by American Spine Injury Association (ASIA). Perioperative outcome and complications were documented. All patients were serially followed up between 12 and 32 months as regard pain (VAS), functional status by Kirkaldy Willis Criteria (KWC) and Oswestry Disability Index (ODI); laboratory and radiological outcomes (angle of segmental kyphosis, Lumbar Lordosis (LL) correction and fusion criteria).
RESULTS: Definitive solid bony fusion was seen between 6 and 14 months except 3 cases showed probable fusion. There was significant improvement in VAS, ASIA, laboratory investigations and ODI. One patient (5%) had transient neurological deficit, which resolved completely within 2 months.
CONCLUSIONS: TLTDDS surgery is an effective procedure in treatment of symptomatic LPS and allows abscess evacuation with adequate neural decompression, segmental kyphosis correction and functional improvement.

PMID: 30610978 [PubMed - as supplied by publisher]

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