Anterior versus Posterior Approach in Surgical Treatment of Dorsolumber Spondylodiscitis

Document Type : Original Research Papers

Authors

Orthopedic Surgery Dept., Faculty of Medicine, Benha University

Abstract

Background: Spinal infections exhibit a wide range of clinical signs. The clinical effects can encompass the vertebral bodies, spinal canal, intervertebral discs, and adjacent paravertebral structures. Surgical treatment becomes necessary when there's a presence of neurological deficits, epidural abscess, or the development of kyphotic deformity. Aim: The aim of this thesis is to conduct a comprehensive comparison of the clinical, radiological,. Patients and methods: A prospective cohort study was conducted in Benha university hospital including thirty patients with dorsolumber spondylodiscitis were admitted and managed operatively between May 2020 and June 2023. Patients were divided into two groups. Group (A): 15 patients (50%) were operated via anterior approach and group (B): 15 patients (50%) were operated via posterior approach. The diagnosis was confirmed through a combination of clinical presentation, laboratory analyses, and radiological evaluations. Results: The mean age of patients of group A was 52 ±8 and group B was 52 ±7. The most frequent site in group A was lumbar (46.7%), followed by thoracolumbar (40%) and thoracic (13.3%), while in group B, the most frequent was lumbar (40%), followed by thoracic (33.35) and thoracolumbar (26.7%). Conclusion: Both the anterior and posterior approaches are effective in accomplishing the objectives of surgical intervention for thoracic and lumbar Spondylodiscitis. However, the posterior approach provides notably superior correction of the kyphotic angle, albeit at the cost of increased operative time, prolonged hospital stay, and greater blood loss. Keywords: Spine infection, Spondylodiscitis, approach to spine.

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