Surgical treatment results in patients with nonspecific spondylitis and spondylodiscitis

Background. Currently, there is no common algorithm for the surgical treatment of patients with nonspecific spondylitis and spondylodiscitis.

Aim. To evaluate the surgical treatment results in patients with nonspecific spondylitis and spondylodiscitis and to identify the risk factors for an unfavorable outcome at patients’ discharge.

Materials and methods. Our study included 80 patients operated on between February 1, 2018, and August 31, 2024, in the neurosurgical and purulent surgery departments of City Clinical Hospital No. 13 (now – V.P. Demikhov City Clinical Hospital) because of spondylodiscitis and spondylitis of various etiologies.

Results. The excellent results (patients are fully active – 80–100 points according to Karnofsky performance status (KPS) scale) were achieved in 38 (48 %) patients, moderate disability (patients are able to care for themselves – 50–70 points according to KPS scale) was observed in 21 (26 %) patients, and severe disability (patients are unable to care for themselves, requiring care – 10–40 points according to KPS scale) was observed in 12 (15 %) patients. Postoperative mortality was 11 % (9 patients). The significant correlation between treatment outcome and leukocyte and C-reactive protein levels was observed only before surgery and on the sixth postoperative day.

Conclusion. The significant risk factors influencing the treatment outcome in patients with nonspecific spondylitis and spondylodiscitis include the following: leukocyte level, C-reactive protein level before surgery and on the sixth postoperative day, primary spinal fixation (if indicated), and neurological deficit. 

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