Surgical treatment of aspergillus spondylodiscitis

Four cases of aspergillus spondylodiscitis were treated with operative debr idement and fusion. In this rarely encountered mycotic infection of the spi ne in immunocompromised patients rapid destruction of the intervertebral di sc and vertebral bodies can occur. In advanced cases antimycotic drug thera py is thought to be ineffective and a forcing indication for surgery exists when the destruction is progressive and spinal cord compression is imminen t or manifest. Spinal instrumentation can be of help in maintaining or rest oring spinal stability and maintaining spinal alignment. In our four patien ts the aspergillus spondylodiscitis was successfully eradicated and fusion achieved. In two of three patients with a neurologic deficit, this deficit disappeared. Two patients died within 6 months after the operative treatmen t, due to complications related to the underlying illness. One patient was left with a subtotal paraplegia.