Postoperative Complications In Operated Cases Of Pyogenic Spondylodiscitis
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2016, Vol 2, Issue 2
Abstract
Study Design: A prospective study from January 2013 to December 2015 was conducted at a single tertiary-care institution. Objective - The aim of the study was to identify the postoperative adverse events and characterize recovery from pain and neurologic deficit after surgery for pyogenic spondylodiscitis at thoracolumbar level. Majority of the patients with spondylodiscitis presenting with severe back pain, neurological deficits, spine instability, progressive kyphosis or epidural abscess and usually require surgical intervention. Although prior studies have characterized outcomes after medical management, the morbidity after surgery is poorly defined. Methods: Analysis of change in self-reported pain from Visual Analog Scale (VAS, 0–10 scale) was done. VAS score were collected throughout the postoperative course once in 3 monthly intervals for maximum period of 12 months. Adverse events in postoperative period were noted during the one year follow up period. New-onset or worsening of neurologic deficits were considered neurologic complications in the postoperative period. Results: 40 patients were included in our study; a majority (40%) presented with a neurologic deficit preoperatively. The median length of follow-up was 12 months. It was observed that by end of 3 months there was a statistically significant improvement in VAS. The mean improvement in VAS was from 7.93 to 2.20. 5% of patients required reoperation for surgical site complications. At end of follow up, 5% died, 5% underwent reoperation, and 5% experienced a neurologic complication. Conclusion: We observed significant improvements in VAS in the postoperative period. In the one year follow up period the incidence of overall adverse events was 27.5%. Main risk factors of poor general condition, the co-morbidities and the long duration of symptoms were associated for poor clinical outcome. Patients and clinicians should not only be aware of the postoperative improvement but also the incidence of adverse events after surgery for spondylodiscitis. We reiterate the fact that spinal stabilization in the setting of pyogenic spondylodiscitis is safe and we also asertain that some postoperative wound complications are accepted and be ready to address them.
Authors and Affiliations
Ravikumar TV, Shiv Prasad MS, Yashwanth Kumar, Vinay Jain K, Mahesh k
Keywords
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