Short-term functional outcome and pain assessment after spinal decompression for spondylodiscitis

Spondylodiscitis, though rare, is a serious condition that can lead to disability or death. It may be caused by pyogenic, granulomatous (e.g., tuberculosis, brucellosis, fungal), or rarely, parasitic infections. Pain and neurological deficits typically result from bone destruction, deformity, and mass effect. Various microbiological agents have been identified in the literature, with more frequent spinal infections caused by pyogenic bacteria, such as Staphylococcus aureus, as well as by less common agents, including Mycobacterium tuberculosis and fungi, such as Candida albicans. Between February 2013 and May 2020, patients underwent posterior decompression surgery with specimen collection for microbiological analysis, transpedicular instrumental fixation, and deformity correction. Inclusion criteria were spinal pain, neurological deficit, spondylodiscitis with radiological or MRI confirmation, and positive microbiological results. Patients under 18, those requiring multiple surgeries, or those with degenerative or conservatively managed cases were excluded. Post-surgical treatment included 6 weeks of dual-antibiotic therapy for pyogenic infections, 1 year of antituberculous therapy with four drugs for the first 3 months, and 6 months of antifungal therapy, consisting of 4 weeks of intravenous treatment followed by oral therapy. Descriptive statistical methods were used in this study. Of the 67 patients, 73.13% had lumbar involvement. Thirty underwent single-level fixation; 37 had multi-level fixation. Pain scores (VAS) improved consistently at 6 weeks and 3 months post-op. All patients initially had neurological deficits, with functional improvement shown by better Oswestry Disability Index scores and Frankel grades after surgery. Surgical intervention was effective in relieving pain, correcting deformities, and improving function in spondylodiscitis. Obtaining a microbiological diagnosis during decompression is crucial for guiding targeted therapy and minimizing antibiotic resistance.