{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:44:02Z","timestamp":1769064242575,"version":"3.49.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,1]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Patients with deep wound infections complicating previously placed internal instrumentation have been successfully treated by debridement and prolonged postoperative antibiotic therapy, which avoided removal of the hardware. Comparatively fewer patients with pyogenic discitis and vertebral osteomyelitis (PDVO) have undergone single-stage debridement, arthrodesis, and internal fixation. The purpose of this study was to determine the efficacy of combining debridement, arthrodesis in which iliac autograft is used, and segmental internal fixation in a single-stage procedure for patients in whom nonoperative management of PDVO has failed.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> A retrospective analysis of 17 consecutive patients with PDVO treated between July 1996 and September 1999 was performed. Follow-up data (mean 30 months) included office examinations and telephone interviews, and patients were grouped according to the duration of preoperative antibiotic therapy. All patients experienced significant postoperative reduction in pain, and those with neurological deficits improved. Eleven patients were independently ambulatory, and three required a walker; only five had been ambulating independently preoperatively. Two patients died during the 1st postoperative week of medical complications; another developed a wound dehiscence that was managed with debridement, prolonged antibiotic administration, and removal of the hardware 1 year later. In no case was pseudarthrosis demonstrated on dynamic radiography. Most patients received only a 6-week course of intravenous antibiotics postoperatively.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> The authors conclude that single-stage debridement, arthrodesis, and internal fixation can be effective in the treatment of PDVO. A 6-week course of postoperative intravenous antibiotics may be sufficient in patients with few risk factors. The harvesting of iliac autograft through the same operative exposure may not increase the risk of secondary infection.<\/jats:p>","DOI":"10.3171\/spi.2001.94.1.0001","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:55:30Z","timestamp":1241711730000},"page":"1-7","source":"Crossref","is-referenced-by-count":43,"title":["Single-stage autogenous bone grafting and internal fixation in the surgical management of pyogenic discitis and vertebral osteomyelitis"],"prefix":"10.3171","volume":"94","author":[{"given":"Gregory J.","family":"Przybylski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashwini D.","family":"Sharan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Spinal Disord","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1097\/00002517-199508040-00003","article-title":"Treatment of postoperative wound infections following spinal fusion with instrumentation.","volume":"8","author":"Abbey","year":"1995"},{"key":"b2","series-title":"Spine","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1097\/00007632-198606000-00003","article-title":"Vertebral osteomyelitis. The surgical management of neurologic complications.","volume":"11","author":"Abramovitz","year":"1986"},{"key":"b3","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1016\/S0090-3019(96)00242-X","article-title":"Surgical management of nontuberculous thoracic and lumbar vertebral osteomyelitis: report of 33 cases.","volume":"47","author":"Arnold","year":"1997"},{"key":"b4","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/00000658-194007000-00016","article-title":"The function of the vertebral veins and their role in the spread of metastases.","volume":"112","author":"Batson","year":"1940"},{"key":"b5","series-title":"J Spinal Disord","first-page":"317","article-title":"Instrumentation of the infected and unstable spine: a review of 17 cases from the thoracic and lumbar spine with pyogenic infections.","volume":"10","author":"Carragee","year":"1997"},{"key":"b6","series-title":"J Bone Joint Surg (Br)","first-page":"528","article-title":"Observations on the venous drainage of the human vertebral body.","volume":"55","author":"Crock","year":"1973"},{"key":"b7","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"981","DOI":"10.3171\/jns.1997.86.6.0981","article-title":"Primary reconstruction for spinal infections.","volume":"86","author":"Dietze","year":"1997"},{"key":"b8","series-title":"Spine","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1097\/00007632-199208000-00022","article-title":"Antibiotic-impregnated methylmethacrylate in treatment of infections with spinal instrumentation: case report and technical note.","volume":"17","author":"Dietze","year":"1992"},{"key":"b9","series-title":"J Bone Joint Surg (Br)","first-page":"47","article-title":"Pyogenic nontuberculous spinal infection: an analysis of thirty cases.","volume":"61","author":"Digby","year":"1979"},{"key":"b10","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"19","DOI":"10.2106\/00004623-198365010-00004","article-title":"Pyogenic and fungal vertebral osteomyelitis with paralysis.","volume":"65","author":"Eismont","year":"1983"},{"key":"b11","series-title":"Spine","first-page":"284","article-title":"Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting.","volume":"14","author":"Emery","year":"1989"},{"key":"b12","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.2106\/00004623-197961070-00007","article-title":"A single stage combined surgical approach for vertebral resections.","volume":"61","author":"Fountain","year":"1979"},{"key":"b13","series-title":"Clin Orthop","first-page":"160","article-title":"Management and outcome of pyogenic vertebral osteomyelitis.","volume":"131","author":"Frederickson","year":"1978"},{"key":"b14","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1227\/00006123-198306000-00015","article-title":"Experience with suction-irrigation technique in the management of spinal epidural infection.","volume":"12","author":"Garrido","year":"1983"},{"key":"b15","series-title":"Paraplegia","first-page":"795","article-title":"Management of pyogenic vertebral osteomyelitis with spinal cord compression in the elderly.","volume":"30","author":"Gepstein","year":"1992"},{"key":"b16","series-title":"J Spinal Disord","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1097\/00002517-199306030-00003","article-title":"Salvage reconstruction in acute and late sequelae from pyogenic thoracolumbar infection.","volume":"6","author":"Graziano","year":"1993"},{"key":"b17","series-title":"Semin Spine Surg","first-page":"268","article-title":"Postoperative infection of the spine.","volume":"2","author":"Heller","year":"1990"},{"key":"b18","series-title":"Connect Tissue Res","doi-asserted-by":"publisher","first-page":"101","DOI":"10.3109\/03008208109152130","article-title":"Nutrition of the intervertebral disc\u2014transport and metabolism.","volume":"8","author":"Holm","year":"1981"},{"key":"b19","series-title":"J Bone Joint Surg (Br)","first-page":"715","article-title":"Anterior fusion of the spine for infective lesions in adults.","volume":"55","author":"Kemp","year":"1973"},{"key":"b20","series-title":"J Bone Joint Surg (Am)","first-page":"343","article-title":"Pyogenic osteomyelitis of the spine: an analysis and discussion of 102 cases.","volume":"18","author":"Kulkowski","year":"1936"},{"key":"b21","series-title":"Clin Orthop","first-page":"142","article-title":"Pyogenic vertebral osteomyelitis with paralysis. Prognosis and treatment.","volume":"269","author":"Leibergall","year":"1991"},{"key":"b22","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"975","DOI":"10.3171\/jns.1997.86.6.0975","article-title":"Management of postoperative infections after spinal instrumentation.","volume":"86","author":"Levi","year":"1997"},{"key":"b23","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1002\/ana.410170408","article-title":"Decreased morbidity from acute bacterial spinal epidural abscesses using computed tomography and neurosurgical treatment in selected patients.","volume":"17","author":"Leys","year":"1985"},{"key":"b24","series-title":"Clin Orthop","first-page":"99","article-title":"Postoperative posterior spinal wound infections.","volume":"284","author":"Massie","year":"1992"},{"key":"b25","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"672","DOI":"10.2106\/00004623-198567050-00002","article-title":"Complications following Harrington instrumentation for fractures of the thoracolumbar spine.","volume":"67","author":"McAfee","year":"1985"},{"key":"b26","series-title":"J Spinal Disord","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1097\/00002517-199407030-00002","article-title":"The fate of autogenous bone graft in surgically treated pyogenic osteomyelitis.","volume":"7","author":"McGuire","year":"1994"},{"key":"b27","series-title":"Clin Orthop","first-page":"56","article-title":"Kyphosis secondary to infectious disease.","volume":"128","author":"O'Brien","year":"1977"},{"key":"b28","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1016\/0090-3019(90)90047-S","article-title":"Diagnosis and management of pyogenic vertebral osteomyelitis in adults.","volume":"33","author":"Osenbach","year":"1990"},{"key":"b29","series-title":"Clin Orthop","first-page":"178","article-title":"Analysis of 61 cases of vertebral osteomyelitis.","volume":"264","author":"Patzakis","year":"1991"},{"key":"b30","series-title":"The Practice of Neurosurgery.","first-page":"3467","article-title":"Vertebral osteomyelitis and disc space infections","author":"Przybylski","year":"1996"},{"key":"b31","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1097\/00006123-199605000-00013","article-title":"Neurosurgical management of thoracic and lumbar vertebral osteomyelitis and discitis in adults: a review of 43 consecutive surgically treated patients.","volume":"38","author":"Rath","year":"1996"},{"key":"b32","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/0090-3019(92)90152-D","article-title":"Surgical treatment of the spontaneous spinal epidural abscess.","volume":"37","author":"Rea","year":"1992"},{"key":"b33","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1136\/jnnp.51.6.803","article-title":"Stabilisation of the infected spine.","volume":"51","author":"Redfern","year":"1988"},{"key":"b34","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1097\/00006123-199905000-00047","article-title":"Contemporary management of spinal osteomyelitis.","volume":"44","author":"Rezai","year":"1999"},{"key":"b35","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"524","DOI":"10.2106\/00004623-199504000-00004","article-title":"Delayed infections following posterior spinal instrumentation for the treatment of idiopathic scoliosis.","volume":"77","author":"Richards","year":"1995"},{"key":"b36","series-title":"Clin Orthop","first-page":"190","article-title":"Vertebral body osteomyelitis: spectrum and natural history. A retrospective analysis of 37 cases.","volume":"118","author":"Ross","year":"1976"},{"key":"b37","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1097\/00007632-199809010-00018","article-title":"Sequential or simultaneous, same-day anterior decompression and posterior stabilization in the management of vertebral osteomyelitis of the lumbar spine.","volume":"23","author":"Safran","year":"1998"},{"key":"b38","series-title":"Rev Infect Dis","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1093\/clinids\/1.5.754","article-title":"Pyogenic vertebral osteomyelitis: report of nine cases and review of the literature.","volume":"1","author":"Sapico","year":"1979"},{"key":"b39","series-title":"Semin Spine Surg","first-page":"95","article-title":"Bacterial vertebral osteomyelitis and epidural abscess.","volume":"2","author":"Schwartz","year":"1990"},{"key":"b40","series-title":"N Z Med J","first-page":"62","article-title":"Pyogenic spinal osteomyelitis: a review of 61 cases.","volume":"99","author":"Silverthorn","year":"1986"},{"key":"b41","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"879","DOI":"10.3171\/jns.1989.70.6.0879","article-title":"Anterior cervical debridement and strut-grafting for osteomyelitis of the cervical spine.","volume":"70","author":"Stone","year":"1989"},{"key":"b42","series-title":"Spine","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1097\/00007632-199108000-00020","article-title":"Postoperative infections in spinal implants. Classification and analysis\u2014a multicenter study.","volume":"16","author":"Thalgott","year":"1991"},{"key":"b43","series-title":"J Bone Joint Surg (Br)","first-page":"796","article-title":"The vascular anatomy of the spine and its relationship to pyogenic vertebral osteomyelitis.","volume":"41","author":"Wiley","year":"1959"},{"key":"b44","series-title":"Orthop Clin North Am","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/S0030-5898(20)31677-1","article-title":"Infectious disease of the spine. Diagnostic and treatment considerations.","volume":"22","author":"Wisneski","year":"1991"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/94\/1\/article-p1.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/94\/1\/article-p1.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/94\/1\/article-p1.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T20:41:27Z","timestamp":1681591287000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/94\/1\/article-p1.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,1]]},"references-count":44,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/spi.2001.94.1.0001","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2001,1]]}}}