Brace treatment results of thoracolumbar vertebral osteomyelitis

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Published Sep 27, 2023
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Vol. 101 No. 5 (2023): Tunis med may 2023

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Sofiane Masmoudi
Orthopedic surgery department, Rabta Teaching Hospital
Mohamed Ali Khlif
Orthopedic surgery department, Rabta Teaching Hospital
Yosri Abcha
Orthopedic surgery department, Rabta Teaching Hospital
Haythem Ellech
Orthopedic surgery department, Rabta Teaching Hospital
Maher Barsaoui
Orthopedic surgery department, Rabta Teaching Hospital
Khaled Zitouna
Orthopedic surgery department, Rabta Teaching Hospital

Abstract

Introduction: Vertebral osteomyelitis is a destructive affection for disc and vertebral body leeding to deformities that disturb coronal and sagittal balance of the spine. Brace immobilization ought to reduce the damage caused by these deformities in long term follow up. Unfortunately, results of this therapy has never be reported


Aim: Describe results of brace immobilization in thoraco-lumbar vertebral osteomyelitis.


Methods: We reported a retrospective descriptive study during 10 years in 31 patients treated for vertebral osteomyelitis in which a brace immobilization was performed. MRI were performed before and after immobilization and then different radiologic segmental parameters were mesured.


Results: The mean age was 54. Koch bacillus was the identified in 19 cases. Vertebral comression rate was significantly higher in thoracic localisation at diagnosis (p=0,021). It evolved from 25% to 33%. Neither the vertebral compression rate at diagnosis nor the period between diagnosis and immobilization were related to this progression. Mean progression of segmental angulation was 3,13°. Vertebral kyphosis was 11° before and after brace immobilization. Lombar lordosis evolved from -42° to -43°. Lombar lordosis was at least stabilised in 92% of patients up to 70 Kg in weight (p=0,013). Thoracic kyphosis evolved from 48° to 51° after immobilization.


Conclusion: At diagnosis, vertebral compression was higher in thoracic localisations. In vertebral osteomyelitis, brace immobilization was more effective in lombar than thoracic localisations and in patients up to 70 Kg in weight.

Keywords:

Brace, Infection, Vertebral osteomyelitis, Spine, Spinal parameters

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