Evaluation of Outcomes of Surgical Treatment for Nonspecific Infectious Spondylodiscitis Via Posterior Approach in One Center.

The Use of Posterior Approach for Surgical Treatment of Nonspecific Spondylodiscitis.

Non-specific spondylodiscitis is a bacterial infection of the spine that in some cases requires surgical treatment. The basis of surgical treatment is the removal of affected tissues. In this case, the supportive function of the affected area is lost, which also requires stable fixation. Access to the affected part of the spine can be achieved through both anterior and posterior approaches. There is no reliable data yet confirming the advantages of each approach. Our study demonstrated successful surgical treatment of infection foci using posterior approach, no neurological or other complications were occurred. Older patients shown differences in hemoglobin levels, postoperative pain scores, the number of affected vertebrae, types of bacteria and recurrent rate.

Study Overview

• Status: Completed
• Conditions: Spondylitis; Osteomyelitis; Spondylodiscitis; Discitis; Pyogenic Infections; Spinal Infection
• Intervention / Treatment: Procedure: Posterior approach to infection site

Detailed Description

This retrospective study was conducted on 38 patients with spondylodiscitis treated using a posterior approach. Clinical data were evaluated in four age groups: under 39 years, 40-49 years, and 50-59 years and over 60.

• Study Type: Interventional
• Enrollment (Actual): 47
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Russia
  • Chuvashskaya Respublika
    • Cheboksary, Chuvashskaya Respublika, Russia, 428020
      • Federal Center of Traumatology, Orthopedics and Arthroplasty

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

- a deep infection affecting intervertebral discs and adjacent vertebral bodies in thoracolumbar spine region which were classified as B.3.1-2 and C2-C4 according to the Pola classification

Exclusion Criteria:

• cervical spine region infection
• unwilling to participate in the study,
• patients with SD of a specific etiology
• patients who received only conservative treatment,
• patients with intradural infections.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Posterial approach; All patients with spondilodiscitis admitted to surgical treatment in one center. During the operation, a posterior approach was used to access the source of infection. The incision of the skin, subcutaneous fat, and aponeurosis was made with the patient in the prone position, projecting through the spinous processes of the vertebrae above the infection site and one adjacent vertebra.

Procedure: Posterior approach to infection site; For the posterior approach, an incision through the skin, subcutaneous fat, and aponeurosis was made with the patient in the prone position, projecting through the spinous processes of the vertebrae above the infection site and one adjacent vertebra. In all cases, a thorough exploration and debridement of the infection site was performed. Bone biopsies were taken from suspected infection sites in all patients for culture.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Surgery time	Surgery time in minutes	From enrollment to the end of surgery at 1 year
Hospital stays	Hospital stays in day	From enrollment to the end of surgery at 1 year
Re-operation	Re-operation number	From enrollment to the 1-year post-surgical treatment follow-up period
VAS-pain after surgery	VAS-pain on the 2nd day after surgery. Visual analog scale (0-10 VAS) and it was categorized using the following terms : no pain (0), mild (1-3), moderate (4-6), severe (7-9), or worse pain.	On the 2nd day after surgery
VAS-pain after discharge	VAS-pain on the 2nd day after discharge. Visual analog scale (0-10 VAS) and it was categorized using the following terms : no pain (0), mild (1-3), moderate (4-6), severe (7-9), or worse pain.	On the 2nd day after discharge
Blood loss during surgery	Blood loss during surgery in ml	During the intervention
Procalcitonin	Procalcitonin level in the blood in ng/mL	On the 2nd day after surgery
C-reactive protein	C-reactive protein in the blood in mg/L (Less than less than 3 mg/L consider be normal)	On the 2nd day after surgery
ESR	Erythrocyte sedimentation rate in mm/hr. Normal ESR ; <20mm/hr.	On the 2nd day after surgery
White blood cells	White blood cells. The normal number of WBCs in the blood is 4.5 to 11.0 × 109/L.	On the 2nd day after surgery
Hemoglobin	Hemoglobin level in grams per deciliter. Normal hemoglobin for men ranges from 13.5 to 17.5 g/dL. Normal range for women is 12.0 to 15.5 g/dL.	On the 2nd day after surgery
Health Questionnaire EuroQol 5 Dimension five levels (EQ-5D-5L)	The EQ-5D-5L descriptive system uses five dimensions and five levels of severity in each dimension. TThe five dimensions include mobility, self-care, activities of daily living, pain and discomfort, and anxiety and depression. The five levels in each dimension are worded as (1) 'not /no problems', (2) 'slight problems', (3) 'moderate problems', (4) 'severe problems' and (5) 'unable to' (mobility, self-care, usual activities), 'extreme' (pain/depression), or 'extremely' (anxiety/depression). Their responses are coded as a number (1, 2, 3, 4 or 5) that corresponds to the respective level of severity: 1 indicates no problems, 2-4 some problems and 3 extreme problems. In this way, a person's health state profile can be defined by a 5-digit number, ranging from 11111 (having no problems in any of the dimensions) to 55555 (having extreme problems in all the dimensions). The assigning of a value to an EQ-5D state is based on the time trade-off (TTO) approach.	From enrollment to the end of surgery at 1 year

Collaborators and Investigators

• Sponsor: Federal State Budgetary Organization, Federal Center for Traumatology, Orthopedics and Arthroplasty

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2019
• Primary Completion (Actual): January 1, 2023
• Study Completion (Actual): January 1, 2023

Study Registration Dates

• First Submitted: November 26, 2025
• First Submitted That Met QC Criteria: January 14, 2026
• First Posted (Actual): January 20, 2026

Study Record Updates

• Last Update Posted (Actual): January 22, 2026
• Last Update Submitted That Met QC Criteria: January 21, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Spondylodiscitis; posterior approach; pyogenic; microbiological profiles
• Additional Relevant MeSH Terms: Bone Diseases; Musculoskeletal Diseases; Infections; Bone Diseases, Infectious; Spinal Diseases; Spondylitis; Osteomyelitis; Discitis
• Other Study ID Numbers: 2024-2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No