[First results of anterior versus posterior instrumentation-fusion in the treatment of spondylodiscitis]. / Erste Ergebnisse ventraler versus dorsaler Instrumentation nach Ausräumung und intervertebraler Fusion bei Spondylodiszitis.

ABSTRACT

AIM: The present study on spondylodiscitis patients was carried out to compare prospectively and randomized the results of clinical and radiological outcomes of anterior versus posterior instrumentation after debridement and grafting. We aimed to make a recommendation concerning the optimum treatment of spondylodiscitis. METHOD: A total of 22 patients with spondylodiscitis were enrolled in the randomized trial to undergo an operation with anterior or posterior instrumentation after debridement and fusion with autologous bone transplant. 12 patients (group 1) were assigned to posterior Universal Spine System stabilization. 10 patients (group 2) were treated with anterior VentroFix instrumentation. In a prospective clinical investigation we have examined both operative therapies with regard to clinical and radiological outcome. The follow-up was one year. RESULTS: In patients with ventral Spondylodesis (group 2), prior recreation of patients was achieved in clinical examination and blood tests. Radiological results are even equivalent in both groups. Therefore we recommend ventral instrumentation as the superior surgical procedure. But the individual local situation has to enable ventral stabilization. CONCLUSION: We found advantages with anterior instrumentation in comparison to posterior stabilization in patients with spondylodiscitis. Advantages of ventral stabilization cause early mobilization postoperatively without any increase in complication rates. Except for operation time and intraoperative blood loss, no statistical difference were was seen. Important is the individual indication for each method depending on anatomical and clinical signs. Ventral instrumentation should be restricted to cases with sufficient bone stock.