• Ping-Yeh Chiu, Jia-En Chi, Fu-Cheng Kao, Ming-Kei Hsieh, and Tsung-Ting Tsai.
• Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
• World Neurosurg. 2020 Mar 1; 135: e333-e338.

ObjectiveVarious surgical techniques for treating spondylodiskitis have been proposed, but the most appropriate surgical treatment remains controversial. In this study, we propose a new hybrid approach combining the use of cortical bone trajectory screws and pedicle screws with the technique of transforaminal lumbar interbody debridement and fusion. With this method, we can shorten the length of the segment that needs to be fixed, minimize the extent of surgical dissection, and reduce the risk of adjacent level degeneration.MethodsPatients with clinical and radiographic evidences of single-level lumbar spondylodiskitis seen between January and December of 2017 were included in the study. Demographic data, including age and sex, were recorded. The intraoperative details, results of culture, functional outcome, radiologic outcome, and length of hospital stay were recorded.ResultsThe mean age of 15 patients was 62.8 years. The mean operative time was 135 minutes, and the mean blood loss was 260 mL. The culture rate was 80%. The mean Numeric Rating Scale score and Oswestry Disability Index score significantly improved from 6.60 to 2.47 and from 21.20 to 10.20, respectively. No major perioperative complications occurred.ConclusionsWith the proposed hybrid approach using cortical bone trajectory and pedicle screws with the transforaminal lumbar interbody debridement and fusion technique, the damaged anterior column can be debrided and reconstructed, and spinal stabilization can also be achieved.Copyright © 2019 Elsevier Inc. All rights reserved.

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