Surgical treatment for infections of the cervical spine

Non-specific and tuberculous infections of the cervical spine are a rare disease in developed countries. In 1962-1988 in the Orhopaedic Institute Rizzoli 32 patients with spondylitis of the cervical spine were treated. Twenty-nine patients came from Italy and three from Africa. Tuberculous infection was present in 23 patients, non-specific infection in nine. Eight tuberculous infections were in the atlanto-axial junction, the remaining ones at lower levels. The diagnosis was assessed by clinical and X-ray methods, only in four instances it was verified by histological examination. Conservative treatment was provided in 26 patients and surgery in five. In the nine non-specific infections orthopaedic and antibiotic treatment was successful, three patients were operated, their case-histories are presented. All cases of tuberculous inflammations were treated conservatively by immobilization and antituberculous treatment. Only in two surgery was called for due to instability of the spine. Both case-histories are presented. Based on the assembled results, the authors recommend in the discussion indications for and the procedure of conservative treatment and in exceptional cases surgical treatment of infections affecting the cervical spine. Key words: infection of the cervical spine, conservative and surgical treatment.