Extreme lateral interbody fusion (XLIF) as a feasible treatment for thoracolumbar spondylodiscitis: a multicenter Belgian case-series.

INTRODUCTION: Spondylodiscitis is, after tissue sampling, initially managed with intravenous antibiotics. In patients with treatment failure, surgical debridement and stabilization is considered. An anterior or posterior approach has already been reported as a successful surgical access, but is associated with a large exposure and a significant morbidity.

MATERIALS AND METHODS: We present a multicenter Belgian case-series on the use of a minimally invasive XLIF procedure with add-on percutaneous pedicle screw fixation (NuVasive®) for patients with a need for surgical debridement and tissue samples or intractable back pain due to spondylodiscitis. Patient characteristics, microbiology results, antibiotic treatment, pre- and post-operative VAS scores, time to bony consolidation, complications and duration of the hospital stay were collected.

RESULTS: Seven patients with one level spondylodiscitis were included. The mean age 64 years with a mean pre-operative VAS score of 8,86 (+/- 0,90). Post-operative VAS score significantly decreased to 2,57 (-70,3%, p<0,001). Mean antibiotic treatment duration was 8 weeks. Median duration of the hospital stay was 14 days. Patients were followed for one year. Complete bony consolidation was observed in 6 out of 7 patients after 1 year. One patient had a stable pseudarthrosis.

CONCLUSION: These results indicate that XLIF topped off with a percutaneous pedicle screw fixation might be a feasible, safe and valuable choice to surgically treat patients with spondylodiscitis with fast and important improvement in VAS. Further prospective research might strengthen the sparsely existing literature of minimally invasive surgery for spondylodiscitis to provide the best possible care.