Interbody impaction of antibiotic-loaded calcium sulfate beads and morselized bone graft in lumbar bacterial spondylodiscitis: A retrospective case series
Mahmoud A. Ashour, Mohammed A. Hussien, Mina S. ZakiObjectives:
The objective of the study is to assess clinical and radiological results of interbody impaction of antibiotic-loaded calcium sulfate beads with morselized bone graft in treating lumbar bacterial spondylodiscitis.
Methods:
Data of 30 patients with lumbar bacterial spondylodiscitis were retrospectively collected, with a mean age of 59 years, all treated with the same technique of impacting intradiscal calcium sulfate antibiotic beads together with bone graft. Evaluation included clinical and radiological outcomes, time to fusion, fusion rates, and complications.
Results:
Mean follow-up period was 26.4 months. Mean operative time was 152.50 min, and mean intraoperative blood loss was 380 mL. All cases achieved solid fusion within a mean of 5.17 months. Visual Analog Scale and Oswestry disability index scores improved from pre-operative means of 9.53 and 63%, respectively, to post-operative means of 0.97 and 8%, respectively ( p < 0.001). C-reactive protein level also improved from a pre-operative mean of 28.9 to <1 at the last follow-up ( p < 0.001). Only 4 cases (13.3%) had complications (seroma, wound infection, and dehiscence).
Conclusion:
Interbody impaction of antibiotic-loaded calcium sulfate beads together with bone grafting is an effective technique for managing bacterial lumbar spondylodiscitis, enhancing infection eradication and achieving interbody fusion with improved clinical and radiological outcomes.