Interbody Fusion in Pyogenic Thoracolumbar Spondylodiscitis: Current Concepts in Diagnosis and Surgical Management ; A Review

Abstract

Background: Pyogenic spondylodiscitis is a destructive spinal infection involving the intervertebral disc and adjacent vertebral endplates. Thoracolumbar involvement may progress from persistent pain and local infection to vertebral destruction, segmental instability, deformity, abscess formation, and neurological compromise. Although antimicrobial therapy and immobilization remain fundamental components of treatment, selected patients require surgical debridement and reconstruction.

Aim: To review the pathophysiology, clinical diagnosis, imaging assessment, treatment decision-making, and the rationale and available approaches for interbody fusion in pyogenic thoracolumbar spondylodiscitis.

Conclusion: Interbody fusion is an important reconstructive option when pyogenic thoracolumbar spondylodiscitis is complicated by neurological compromise, mechanical instability, progressive deformity, abscess, or failure of conservative treatment. Appropriate selection of anterior, posterior, or combined fusion should be individualized according to the extent and location of infection, anterior column destruction, spinal alignment, and patient-related factors.