Early Intervention in Post-operative Infectious Spondylodiscitis: Outcome of Aggressive Transforaminal Lumbar Interbody Fusion

Introduction: Conservative and surgical approach timeline in post-operative spondylodiscitis (POS) following lumbar disc herniation (LDH) surgery is ill defined, and patients have a protracted recovery phase with social, psychological, and financial implications. Materials and methods: Retrospect...

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Main Authors: Krishnan A, Dave BR, Degulmadi D, Mayi S, Rai R, Bang P, Dave M, Chauhan V, Bali S, Charde P, Anil A, Krishnan P
Format: Article
Language:English
Published: Malaysian Orthopaedic Association 2024-11-01
Series:Malaysian Orthopaedic Journal
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Online Access:https://www.morthoj.org/2024/v18n3/post-operative-infectious-spondylodiscitis.pdf
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author Krishnan A
Dave BR
Degulmadi D
Mayi S
Rai R
Bang P
Dave M
Chauhan V
Bali S
Charde P
Anil A
Krishnan P
author_facet Krishnan A
Dave BR
Degulmadi D
Mayi S
Rai R
Bang P
Dave M
Chauhan V
Bali S
Charde P
Anil A
Krishnan P
author_sort Krishnan A
collection DOAJ
description Introduction: Conservative and surgical approach timeline in post-operative spondylodiscitis (POS) following lumbar disc herniation (LDH) surgery is ill defined, and patients have a protracted recovery phase with social, psychological, and financial implications. Materials and methods: Retrospective analysis of patients operated by transforaminal lumbar interbody fusion (TLIF) in POS was done. Confirmed clinico-radiological diagnosed POS cases, not responding within three to four weeks were included. Normalisation of CRP and radiological stable reconstruction was assessed for objective clearance of POS and bony union. Results: Ninety-five patients were included in the study with minimum follow-up period of two years. The mean age was 51.63±13.63 years. There were organisms cultured in 55 patients (57.89%). The ODI improvement of the patients was noted to improve from 88.71±5.3 to 20.80±9.7 (8 weeks) and was incremental at 2 years follow-up (10.12±6.41) and maintained further at final follow-up at 9±4.3. Bony union achieved in all with stable reconstruction. The resumption of activities of daily living (ADL) was quick (15.90±8.20 days) and job (3.67±1.31 months) was achieved in all the patients. In poor outcomes, two patients didn’t respond, and one patient died due to uncontrolled infection. Conclusion: Early diagnosis and intervention is the key to effective management of POS. Utilisation of aggressive TLIF yields faster ADL resumption.
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spelling doaj-art-4bdeb6edf1c640f7b7c4923b70f1d8ef2025-08-20T02:20:45ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2024-11-0118311110.5704/MOJ.2411.003Early Intervention in Post-operative Infectious Spondylodiscitis: Outcome of Aggressive Transforaminal Lumbar Interbody FusionKrishnan A0Dave BR1Degulmadi D2Mayi S3Rai R4Bang P5Dave M6Chauhan V7 Bali S8Charde P9Anil A10Krishnan P111 Department of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaDepartment of Radiodiagnosis, Stavya Spine Hospital and Research Institute, Ahmedabad, IndiaIntroduction: Conservative and surgical approach timeline in post-operative spondylodiscitis (POS) following lumbar disc herniation (LDH) surgery is ill defined, and patients have a protracted recovery phase with social, psychological, and financial implications. Materials and methods: Retrospective analysis of patients operated by transforaminal lumbar interbody fusion (TLIF) in POS was done. Confirmed clinico-radiological diagnosed POS cases, not responding within three to four weeks were included. Normalisation of CRP and radiological stable reconstruction was assessed for objective clearance of POS and bony union. Results: Ninety-five patients were included in the study with minimum follow-up period of two years. The mean age was 51.63±13.63 years. There were organisms cultured in 55 patients (57.89%). The ODI improvement of the patients was noted to improve from 88.71±5.3 to 20.80±9.7 (8 weeks) and was incremental at 2 years follow-up (10.12±6.41) and maintained further at final follow-up at 9±4.3. Bony union achieved in all with stable reconstruction. The resumption of activities of daily living (ADL) was quick (15.90±8.20 days) and job (3.67±1.31 months) was achieved in all the patients. In poor outcomes, two patients didn’t respond, and one patient died due to uncontrolled infection. Conclusion: Early diagnosis and intervention is the key to effective management of POS. Utilisation of aggressive TLIF yields faster ADL resumption.https://www.morthoj.org/2024/v18n3/post-operative-infectious-spondylodiscitis.pdfpost-operativespondylodiscitislumbardiscectomytlif
spellingShingle Krishnan A
Dave BR
Degulmadi D
Mayi S
Rai R
Bang P
Dave M
Chauhan V
Bali S
Charde P
Anil A
Krishnan P
Early Intervention in Post-operative Infectious Spondylodiscitis: Outcome of Aggressive Transforaminal Lumbar Interbody Fusion
Malaysian Orthopaedic Journal
post-operative
spondylodiscitis
lumbar
discectomy
tlif
title Early Intervention in Post-operative Infectious Spondylodiscitis: Outcome of Aggressive Transforaminal Lumbar Interbody Fusion
title_full Early Intervention in Post-operative Infectious Spondylodiscitis: Outcome of Aggressive Transforaminal Lumbar Interbody Fusion
title_fullStr Early Intervention in Post-operative Infectious Spondylodiscitis: Outcome of Aggressive Transforaminal Lumbar Interbody Fusion
title_full_unstemmed Early Intervention in Post-operative Infectious Spondylodiscitis: Outcome of Aggressive Transforaminal Lumbar Interbody Fusion
title_short Early Intervention in Post-operative Infectious Spondylodiscitis: Outcome of Aggressive Transforaminal Lumbar Interbody Fusion
title_sort early intervention in post operative infectious spondylodiscitis outcome of aggressive transforaminal lumbar interbody fusion
topic post-operative
spondylodiscitis
lumbar
discectomy
tlif
url https://www.morthoj.org/2024/v18n3/post-operative-infectious-spondylodiscitis.pdf
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