PYOGENIC VERTEBRAL OSTEOMYELITIS AND POSTSURGICAL DISC SPACE INFECTIONS

The presentation and clinical course for hematogenous vertebral osteom yelitis and postoperative discitis is presented. The treatment is prim arily conservative care in the form of immobilization and parenteral a ntibiotics. The indications for surgery are rare and should be reserve d for patients resistant to treatment or with septic course, abscess f ormation, or neurologic deficits. In these cases, the infectious proce ss has generally involved the adjacent vertebrae or the neural element s. Surgery usually involves an anterior approach. The principles of su rgical treatment involve debridement of necrotic tissue, decompression of neural elements, and stabilization of the spine. The outcome of pa tients with vertebral osteomyelitis and secondary discitis in general is favorable when appropriate treatment is rendered. Extension of the infection to the spinal canal in the form of an epidural abscess is al so reviewed.