Pyogenic Dorsal and Lumbar Spondylodiscitis treated with Minimally Invasive Endoscopic Procedure and Posterior Percutaneous Instrumentation

Author(s): Rita Macedo Sousa, Carlos Branco, Diogo Sousa, João Reis, André Guimarães, Ricardo Geraldes, Pedro Teixeira Gomes

Introduction: Spondylodiscitis is a rare infection of the intervertebral disc and nearby bone structures, which incidence has been increasing in the past decades. Conservative treatment is the gold standard, but sometimes surgery is needed to relief the symptoms and eradicate the infection, preserve the neurological function, and restore structural alignment and stability.

Case presentation: The authors present a clinical case of a 73-year-old-male with T11-12 and L4-L5 spondylodiscitis with an epidural collection at this last level, treated surgically with an interlaminar endoscopic debridement and posterior percutaneous instrumentation after failing of isolated medical treatment.

Discussion: The diagnosis of spondylodiscitis may sometimes be difficult due to its non-specific symptoms and sometimes inconclusive blood tests. Endoscopic surgery along with posterior percutaneous instrumentation provides a minimally invasive surgical option in multimorbid patients and/or in early stages of the disease, reducing the surgical trauma, complications and fastening the recovery.

Conclusion: Spondylodiscitis is a highly heterogeneous disease, remaining its diagnosis and treatment a complex challenge. With this case report the authors expect to raise awareness to the use of minimally invasive techniques in treating diseases of this type.