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DOI: 10.1055/s-0043-1777272
A Comprehensive Review of Pyogenic Spondylitis Management for Neurosurgeons
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Abstract
Older populations have been increasing recently, resulting in an increase in cases of pyogenic spondylitis. Neurosurgeons who frequently treat the elderly are at a higher risk of encountering this condition. Therefore, this article provides a summary of the literature and our experience to help neurosurgeons effectively manage pyogenic osteomyelitis. It is important not to rule out pyogenic spondylosis when examining a patient with back pain, even in the absence of a fever. This is because the chronic type is common, easily overlooked, and early diagnosis and treatment are crucial. Empirical antibiotics should be avoided in cases where blood culture and biopsy are negative, to prevent microbial resistance and an increase in difficult-to-treat cases. Biopsies, such as computed tomography-guided percutaneous biopsy and full endoscopic debridement and drainage, should be attempted. Currently, 6 weeks of parenteral antibiotic therapy is the main treatment for pyogenic spondylitis. Surgical treatment is recommended if this method is ineffective. However, in the early stages, full endoscopic debridement and drainage and percutaneous pedicle screw fixation are optional.
Keywords
conservative treatment - management - neurosurgeons - pyogenic spondylitis - surgical treatmentPublication History
Article published online:
29 December 2023
© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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