The surgical treatment of pyogenic spondylitis using posterior instrumentation without anterior debridement

The Bone & Joint Journal, 06/08/2012

Fushimi K et al. – Single–stage posterior fusion may be effective in patients with pyogenic spondylitis who have relatively minor bony destruction.


  • The authors report the clinical outcomes of six patients with pyogenic spondylitis treated effectively with a single–stage posterior fusion without anterior debridement at a mean follow–up of 2.8 years (2 to 5).
  • Haematological data, including white cell count and level of C–reactive protein, returned to normal in all patients at a mean of 8.2 weeks (7 to 9) after the posterior fusion.


  • Rigid bony fusion between the infected vertebrae was observed in five patients at a mean of 6.3 months (4.5 to 8) post–operatively, with the remaining patient having partial union.
  • Severe back pain was immediately reduced following surgery and the activities of daily living showed a marked improvement.
  • Methicillin–resistant Staphylococcus aureus was detected as the causative organism in four patients.

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