THE ROLE OF MINIMALLY INVASIVE SPINE SURGERY IN THE MODERNAPPROACH TO SPONDYLODISCITIS TREATMENT

Abstract

As one of the most difficult-to-treat and rapidly increasing infections in neurosurgery today, spondylodiscitis presents a unique challenge from diagnostic, therapeutic, and rehabilitative perspectives. While conservative antibiotic therapy has traditionally been the primary approach, modern surgical techniques increasingly offer methods that not only assist treatment but have the potential to fundamentally change the management of this type of spinal infection. We present the treatment outcomes of 16 patients who underwent various surgical techniques, achieving better clinical and paraclinical results by day 30 compared to a control group treated conservatively with intravenous antibiotics followed by oral therapy at home, without surgical intervention. Follow-up tests on days 1, 7, 15, and 30 showed a faster paraclinical response – specifically in inflammatory markers (CRP, ESR) – in patients who underwent surgery as an adjunct to antibiotic therapy. The study concludes that not only does the surgical approach reduce the incidence of subsequent spinal instability and epidural compression in cases of poor response to conservative therapy, but it also significantly shortens hospital stay when the infection is treated with a hybrid approach involving minimally invasive instrumentation and either open or percutaneous biopsy from the inflammatory site.