Single-stage Treatment of Osteomyelitis of the Cervical Spine Using Anterior Instrumentation and Titanium Mesh Cages

Study Design. A case series. Objective. The aim of this study was to evaluate the clinical outcomes of patients with osteomyelitis of the cervical spine who were treated with single-stage anterior debridement and fusion using titanium mesh cages along with anterior plates. Summary of Background Data. There have been few studies in single-stage surgical treatment of osteomyelitis of the cervical spine using titanium mesh cages along with anterior plates. Methods. Twenty-four patients treated for osteomyelitis of the cervical spine are presented. There were 11 male and 13 female with an average age of 53.3 years (42–63). Seventeen patients presented with a neurologic deficit at the time of diagnosis. Surgical treatment consisted of anterior debridement and fusion using titanium mesh cages along with anterior plates as a one-step procedure. The patients’ records and radiographs were retrospectively analyzed and follow-up clinical and radiographic data obtained. Results. The median follow-up period was 52 months. There were no implant failures. All patients showed a solid bony fusion without any recurrence of infection at latest follow-up. Changes in pain level, hematologic parameters, and neurologic status demonstrated a significant clinical improvement in all patients. Conclusion. This single-stage surgical treatment for osteomyelitis of the cervical spine provided satisfactory results. There is no increased risk of recurrence or persistence of infection related to the implantation of titanium mesh cages and instrumentation. Level of Evidence: 4

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