Prognostic factors in management of postoperative spondylodiscitis

Background Spinal infection is an uncommon disease, which may result in serious complications with potentially high morbidity and mortality. Objective The aim was to evaluate the outcome of patients with postoperative spondylodiscitis after management in relation to age, sex, general condition, symptoms, signs, radiological findings, type, and time of intervention. Patients and methods A prospective study was conducted on 20 patients having postoperative spinal infection managed in the period between June 2017 to June 2019 in the Neurosurgery Department at Menoufia University Hospitals and Al Haram Hospital. Patients with postoperative spinal infection were evaluated neurologically by American Spinal Injury Association (ASIA) score, pain was evaluated by Denis score, and they were followed up radiologically by MRI and radiography for assessment of their neurological integrity, deficits, and outcome. Results There was a statistically significant difference between postmanagement Denis pain score, ASIA score, and C-reactive protein as compared with before management (P<0.001). Outcome of the 20 patients was categorized according to Odom's criteria as follows: 12 (60%) patients had excellent outcome, six (30%) patients had good outcome, one (5%) patient had fair outcome, and one (5%) patient had poor outcome. Conclusion Among the wide variety of organisms responsible for postoperative spinal infection, we found that Staphylococcus aureus accounted for most of it. The best modality of treatment is medical treatment with antibiotics and surgical management when failure of the medical one or presence of neurological deficits.