• Eur Spine J · Dec 2023

    Recurrence rate after posterior percutaneous screw fixation without anterior debridement for pyogenic spondylitis compared with conservative treatment: a propensity score-matched analysis.

    • Soichiro Masuda, Takayoshi Shimizu, Takashi Sono, Yasuyuki Tamaki, Eijiro Onishi, Mitsuru Takemoto, Seiichi Odate, Hiroaki Kimura, Masanori Izeki, Takuya Tomizawa, Naoya Tsubouchi, Shunsuke Fujibayashi, Bungo Otsuki, Koichi Murata, and Shuichi Matsuda.
    • Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. smasuda0306@gmail.com.
    • Eur Spine J. 2023 Dec 1; 32 (12): 426542714265-4271.

    PurposePrevious studies have shown that percutaneous pedicle screw (PPS) posterior fixation without anterior debridement for pyogenic spondylitis can improve patient quality of life compared with conservative treatment. However, data on the risk of recurrence after PPS posterior fixation compared with conservative treatment is lacking. The aim of this study was to compare the recurrence rate of pyogenic spondylitis after PPS posterior fixation without anterior debridement and conservative treatment.MethodsThe study was conducted under a retrospective cohort design in patients hospitalized for pyogenic spondylitis between January 2016 and December 2020 at 10 affiliated institutions. We used propensity score matching to adjust for confounding factors, including patient demographics, radiographic findings, and isolated microorganisms. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for recurrence of pyogenic spondylitis during the follow-up period in the matched cohort.Results148 patients (41 in the PPS group and 107 in the conservative group) were included. After propensity score matching, 37 patients were retained in each group. PPS posterior fixation without anterior debridement was not associated with an increased risk of recurrence compared with conservative treatment with orthosis (HR, 0.80; 95% CI, 0.18-3.59; P = 0.77).ConclusionsIn this multi-center retrospective cohort study of adults hospitalized for pyogenic spondylitis, we found no association in the incidence of recurrence between PPS posterior fixation without anterior debridement and conservative treatment.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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