Autogenous Bone Grafts versue Metal Cage with Allogenic Bone Grafts for Post-Corpectomy Anterior Column Reconstruction in Patients with Infectious Spondylitis

摘要

Objective To evaluate and compare the clinical and radiographic features of 25 patients with infectious spondylitis treated with anterior debridement and reconstruction using autogenous bone grafts vs. a metal cage with allogenic bone grafts. Methods The study analyzed 25 patients diagnosed with infectious thoracolumbar spondylitis who underwent anterior radical debridement and reconstruction. Autogenous bone grafts were used in 13 patients (group 1), and a metal cage with allogenic bone grafts was used in 12 patients (group 2). Clinical outcomes were assessed by the visual analogue scale (VAS) scores and neurological status. Additionally, the serological results and the radiographic results using the sagittal Cobb angle were compared. Fusion was evaluated by computed tomography (CT) imaging at 24 months postoperatively. Results Both groups showed a significant decrease in the postoperative mean VAS scores; however, only, group 1 patients showed a significantly higher VAS score than group 2 patients, 1 month postoperatively (p=0.002). The postoperative neurological status significantly improved. Elevated C-reactive protein levels and erythrocyte sedimentation rate values returned to normal limits at the 2-year follow-up without recurrent infection. No significant intergroup difference was observed in Cobb angle. Bony fusion was confirmed in all patients at CT 24 months postoperatively. Conclusion Although the use of a metal cage with allogenic bone grafts for anterior column reconstruction remains controversial, our results suggest that it can be considered as an effective treatment of option for anterior column reconstruction in patients with infectious spondylitis.