Surgical outcomes of minimally invasive microscopic debridement in thoracolumbar pyogenic spondylodiscitis

Thoracolumbar infectious spondylodiscitis is a serious condition that often requires surgical intervention if conservative treatment fails. Debridement and drainage are crucial in removing infected tissues and achieving adequate control of the source of infection. In this study, we aimed to evaluate the surgical outcomes of microscopic debridement in patients with thoracolumbar spondylodiscitis. We retrospectively reviewed the data of 128 patients treated for thoracolumbar spinal infections between March 2017 and December 2021. Overall, 40 patients with spondylodiscitis who underwent only microscopic debridement were included in the study. Patient demographics, clinical characteristics, laboratory results, surgical details, and clinical outcomes were analyzed. Of 40 patients, 28 had bone destruction. Patients with bone destruction showed poorer initial clinical outcomes, higher low back pain, worse disability, and lower quality of life scores than those without it. However, the long-term outcomes were favorable, with 63% achieving spontaneous bone union and all patients showing resolution of instability. However, 14% of the patients with bone destruction required further fusion surgery. Microscopic debridement results in favorable clinical outcomes in patients with thoracolumbar spondylodiscitis, including those with bone destruction. This approach is a potential alternative to fusion surgery, particularly in patients with a poor general condition.