Surgical Management of Post-Discectomy Spondylodiscitis with Transforaminal Lumbar Interbody Fusion and Posterior Instrumentation

Abstract

OBJECTIVE: To treat the post-discectomy spondylodiscitis, transforaminal lumbar interbody fusion (TLIF) and the posterior instrumentation performed. METHODOLOGY: This retrospective study was conducted at Khyber Medical College Peshawar from July 2021 to June 2023. Surgery with TLIF and posterior spinal instrumentation was used to treat nine patients (ages 38 to 68; mean ages 47.8 years) having post-lumbar discectomy spondylodiscitis. Despite receiving a thorough conservative treatment plan that included a brace and broad-spectrum antibiotics, every patient still experienced substantial back discomfort. With an average of 22 months, the follow-up lasted between 12 and 36 months. All patients were accessible for the follow-up procedures, including physical examinations, radiography, and function assessment. We looked at the length of the procedure, blood loss, and complications to gauge how invasive it was. The surgical result was assessed using the activities of daily living (ADL) (Barthel index), visual pain analog scale (VPAS), ESR, and CRP in the pre-operative, post-operative, and final follow-up periods. RESULTS: At the last follow-up visit, Barthel and VPAS indices were enhanced in all the patients even though we had experienced some post-operative problems, such as wound infection. In each case, variations in ESR and CRP showed infection suppression. CONCLUSION: Patients experience positive outcomes following surgical management of post-operative spondylodiscitis using TLIF and posterior spinal instrumentation.

Keywords

• transforaminal lumbar interbody fusion
• surgical management pyogenic spondylodiscitis