We reviewed 36 patients who had been diagnosed as pyogenic spondylitis in our department between 1987 and 2002. All patients were treated conservatively at first by the administration of intravenous antibiotics and the bed rest with orthobrace. Twenty-six patients were treated by this conservative therapy alone (conservative group), and the remaining 10 were obliged to undergo operative therapy (operative group) because of the poor reaction to chemotherapy (6 cases) and the appearance of neurological deterioration (4 cases). In the conservative group, clinical results were good in 23 patients and poor in 3 patients suffering general complications including diabetes mellitus, rheumatoid arthritis and gastric cancer. In the surgical group, neurological deficits remained in 2 patients.
Although the application of spinal instrumentation for osteomyelitis surgery is still controversial, it is considered to be a good modality for cases whose inflammatory signs become negative.
