SALVAGE RECONSTRUCTION IN ACUTE AND LATE SEQUELAE FROM PYOGENIC THORACOLUMBAR INFECTION

Nine patients treated surgically for complicated pyogenic osteomyeliti s of the thoracolumbar spine are reported. All patients were treated w ith anterior debridement and stabilization with nonvascularized autoge nous fibular strut grafts. In addition, seven underwent a posterior sp inal fusion with instrumentation. The average length of follow-up was 25 months. There was no recurrence of infection, no pseudoarthrosis, a nd the fibular struts appeared incorporated in all patients. Seven pat ients had postoperative improvement or resolution of their back pain. The use of nonvascularized autogenous fibular strut grafts for reconst ruction of the spine following debridement for vertebral osteomyelitis is an effective procedure. The advantages of using the fibula for gra fting are its strength and length for spanning several vertebral segme nts, and it can provide multiple grafts.