Surgical treatment of inflammation processes of the spine

Introduction. In the last two decades, we observe an increasing incidence of spine infections. In the clinical image, we observe full diversification of symptoms – from longstanding, slowly increasing pain in the back to sudden and acute beginnings with septic state, extremely acute pain of the spinal column and quickly increasing neurological losses. Indications for surgical intervention are: compressions of nervous tissue, lack of stability of the spine dependent on bone destruction, ineffectiveness of conservative procedure and treatment of the not receding pain. Aim. The introduction of metal implants in the area of spine infection still arises objection among some surgeons, especially when in ‘in-vitro’ tests a bacterial biofilm was detected on the surface of the metal, resistant to the action of antibiotics. The aim of our work is the evaluation of the results of surgical treatment of spine inflammatory processes in different age groups with the use of spine implants. Material and method: A group of 92 patients were examined, aged from 4 to 88, surgically treated due to spine inflammatory process. The diagnosis was made on the basis of radiological examinations: rentgenographic imaging, computer-assisted-tomography and magnetic resonance. In the surgical treatment, we applied different techniques depending on the localisation of the process and destructive changes within the spine. Corporectomy with stabilisation on titanum net and screws was made from frontal access – 57% patients, and discsectomy without implant – 9% of operated patients. Discsectomy without implant from posterior access was carried out in 8% patients, discsectomy with stabilisation PLIF method – 13% patients, and decompression of the spine canal and transpedicular stabilisation – 13% patients. In general, in 86% patients, we carried out an intervention with implant graft. Results: In 70% of the group after primary intervention, we achieved improvement of the clinical state, confirmed in rentgenographic and laboratory tests (OB, C-reactive protein, Lukocytosis). In the remaining group (30% patients) there were different disadvantageous symptoms, requiring other surgical interventions. The follow-up period amounted on average to 4 years and 2 months. Conclusions: Surgical treatment is a method of choice in patients with a lack of improvement in conservative treatment, with increasing spine deformity and neurological losses. Resection of inflammatory changes in healthy tissues and correct spine stabilisation with the use of implants are a condition for the cure of the inflammatory process.