[Operative therapy for intraspinal empyema: a retrospective study of 23 patients]. / Operative Therapie intraspinaler Empyeme: Eine retrospektive Untersuchung von 23 Patienten.

OBJECTIVE: Intraspinal empyema is a rare entity in spinal surgery. This study analyses the results after operating in 23 patients. MATERIAL AND METHODS: This is a retrospective study of 23 patients suffering from intraspinal empyema treated operatively in our department. The data were obtained by analysing the patient documents including the radiological and microbiological data. RESULTS: 18 patients suffered from different neurological deficits ranging from isolated mild hypaesthesia to paraplegia (n = 3). The operation was done as a one-level (n = 13), two-level (n = 8)or three-level (n = 2) microsurgical fenestration followed by irrigation and drainage of the pus. Staphylococcus aureus was the most frequent triggering organism. After a follow-up of 7 months 1 patient had died because of septic complications. Neurological deficits improved in 14 patients but 3 patients were still disabled in their daily life. CONCLUSION: Epidural spinal empyema remains a challenge in spine surgery. Persistent neurological deficits and lethal complications make it a severe problem. Management comprises urgent surgical evacuation of the pus followed by targeted antibiotic therapy.

[Operative therapy of bacterial spondylodiscitis: a retrospective study]. / Operative Therapie der bakteriellen Spondylodiszitis: Eine retrospektive Untersuchung.

OBJECTIVE: Bacterial spondylodiscitis is a rare entity in spinal surgery. This study analyses the postoperative results of 53 patients, focusing on the history, the treatment, and the course of the disease. MATERIAL AND METHODS: This retrospective study is based on the patients' medical charts, including the laboratory and microbiological data. RESULTS: Twenty-nine patients suffered from different neurological deficits ranging from isolated mild hypaesthesia (n=1) to complete paraplegia (n=6). Depending on the affected area and the extension of the infection, surgery was done either as simple decompression in 16 cases or as decompression combined with a ventral or dorsoventral stabilization in 37 patients. Staphylococcus aureus was the most important triggering organism (n=23). After a median follow-up of 11.25 months, three patients had died, and 22 patients were still disabled because of persisting pain or neurological disturbances. CONCLUSION: Because of persistent neurological deficits and possible lethal complications, spondylodiscitis remains a severe problem. Management comprises targeted antibiotic therapy and surgery in selected cases.