Anterior cervical debridement and strut-grafting for osteomyelitis of the cervical spine

J. L. Stone, G. R. Cybulski, J. Rodriguez, M. E. Gryfinski, R. Kant

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

A retrospective review of the surgical experience in treating 18 patients with osteomyelitis of the cervical spine is reported. The patients ranged in age from 20 to 60 years and all complained of neck pain upon admission. Ten patients had a prior history of intravenous drug abuse, three had previously suffered penetrating injuries of the neck, and one had an extraspinal site of osteomyelitis. Bacteria were isolated in 13 cases and tuberculosis in three. Neurological abnormalities were present in over one-half of the patients, consisting of myelopathy (nine cases) or radiculopathy (four cases). Plain cervical spine films and polytomography demonstrated vertebral and end-plate destruction, spinal instability, and increased paravertebral soft-tissue shadow in all cases. Computerized tomography and, more recently, magnetic resonance imaging have proven helpful in detecting bone involvement and the presence of epidural extension associated with cervical osteomyelitis. The risk of vertebral body collapse, kyphosis, and myelopathy in the osteomyelitic cervical spine has standardized the management of this problem in this institution to consist of skeletal traction, needle aspiration or blood culture for organism identification, anterior cervical debridement, autogenous iliac graft fusion, and intravenous administration of antibiotics. Spinal stability and neurological improvement were achieved in all 18 patients.

Original languageEnglish (US)
Pages (from-to)879-883
Number of pages5
JournalJournal of Neurosurgery
Volume70
Issue number6
DOIs
StatePublished - Jan 1 1989

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Stone, J. L., Cybulski, G. R., Rodriguez, J., Gryfinski, M. E., & Kant, R. (1989). Anterior cervical debridement and strut-grafting for osteomyelitis of the cervical spine. Journal of Neurosurgery, 70(6), 879-883. https://doi.org/10.3171/jns.1989.70.6.0879