Single-stage debridement and spinal fusion using @entity12316 cages through a posterior approach for eradication of lumbar pyogenic XXXX : a safe treatment strategy for a detrimental condition.

@entity1 @entity1512 @entity51 @entity12316 @entity702
BACKGROUND: Pyogenic infections of the lumbar spine are a rare but critical pathology, yet with considerably high mortality rates. In cases indicating surgical therapy, the implantation of @entity702 cages or autologous bone grafts represent today's gold standard. Although non-metallic implants such as @entity12316 ( @entity12316 ) have proven to be advantageous in diverse degenerative conditions, their saftey and practicability in lumbar spine infection remains questionable. Moreover, the efficacy of a single-step radical debridement of the infected disc space with subsequent fusion from a strictly posterior approach continues to be an issue of debate. We therefore sought to evaluate the feasibility, clinical and radiological outcome of a single-step TLIF procedure using oblique @entity12316 cages in the surgical management of @entity1 with lumbar pyogenic @entity1512 . METHODS: From January 2009 through December 2013, all @entity1 meeting the indication for surgical treatment of lumbar pyogenic @entity1512 were included. @entity1 demonstrating intact cortical bone on preoperative CT received a single-step radical debridement of the infected intervertebral disc space, posterior screw-and-rod instrumentation and implantation of an oblique @entity12316 cage using the TLIF technique. Oral antibiotics were continued for 12  weeks postoperatively and clinical and radiological results recorded throughout a minimum 1-year clinical follow-up. RESULTS: A total of 104 @entity1 were admitted to receive surgical therapy for lumbar pyogenic @entity1512 . Within this @entity1 population, 18 @entity1 met the diagnostic criteria to receive the implantation of an oblique @entity12316 cage. Pathogens were detected in 13 cases with Staph. aureus being the predominant causative organism. All @entity1 were discharged to recover in their domestic environment. Throughout the first year  of clinical and radiological follow-up and beyond, none of the 18 @entity1 demonstrated any signs of @entity51 or recurrent infection. Furthermore, two-plane conventional X-rays showed no significant implant subsidence or failure at any of the given time-points in up to 5 years postoperatively. CONCLUSIONS: In @entity1 meeting the criteria for surgical treatment of lumbar pyogenic @entity1512 , the implantation of @entity12316 cages using a single-step TLIF approach is a safe and feasible procedure. Based on our experience, the concern of a recurrent infection when implanting non-metallic cages may be refuted in carefully selected @entity1 .
