Abstract
Introduction
The aim of this study is to evaluate the outcome after posterior spinal stabilization surgery for the management of de novo non-tuberculous bacterial spinal infection.
Materials and Methods
Patients presenting to a single tertiary referral spinal center between August 2011 and June 2014 were included in the study. 21 patients with non-tuberculous bacterial infection were identified and included in the study. All patients were managed surgically with posterior stabilization, with or without neural decompression, without debridement of the infected tissue. Neurological state was assessed using the Frankel Grading System before and after surgery. medium-term follow-up data was collected using Spine Tango COMI questionnaires and Euro Qol EQ-5D system with a mean follow-up duration of 20 months postoperatively.
Results
The mean improvement in neurological deficits was 0.91 Frankel grade (range 0–4). At a 20 month mean final follow-up, mean COMI score was 4.59, average VAS for back pain was 4.28. These symptoms had no or minor effect on the work or usual activities in 52%. 38% of patients reported a good quality of life. The average EQ-5D value was 0.569. There were no problems with mobility in 44% of patients. In 72% there were no problems with self-care.
Conclusions
Our study has shown that posterior surgery for the management of bacterial, nontuberculous spinal infection can improve neurological outcome in approximately half of the patients. At medium-term follow-up, around 50% of patients were able to return their pre-morbid work or usual activities. Outcomes were comparable to other techniques including anterior or combined surgery.