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European Spine Journal

26-12-2023 | Spondylodiscitis | Review Article

Influence of instrumentation type on outcomes after surgical management of spondylodiscitis: a systematic review and meta-analysis

Authors: Krisna S. Maddy, Joseph Yunga Tigre, Victor M. Lu, Meredith C. Costello, Emily L. Errante, Allan D. Levi, S. Shelby Burks

Published in: European Spine Journal

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Abstract

Objective

Spondylodiscitis refers to infection of the intervertebral disk and neighboring structures. Outcomes based on instrumentation type are not well reported in the literature, but are important in establishing guidelines for surgical management of spondylodiscitis. This study aims to clarify the effect of instrumentation material selection on clinical and radiographic outcomes in patients with spondylodiscitis.

Methods

Studies that evaluated the use of polyetheretherketone (PEEK), titanium, allograft, and/or autologous bone grafts for spondylodiscitis were identified in the literature. Radiographic and clinical data were analyzed using a meta-analysis of proportions, with estimated risk and confidence intervals reported for our primary study outcomes.

Results

Thirty-two retrospective studies totaling 1088 patients undergoing surgical management of spondylodiscitis with PEEK, TTN, allograft, and autologous bone graft instrumentation were included. There were no differences in fusion rates (p-interaction = 0.55) with rates of fusion of 93.4% with TTN, 98.6% with allograft, 84.2% with autologous bone graft, and 93.9% with PEEK. There were no differences in screw loosening (p-interaction = 0.52) with rates of 0.33% with TTN, 0% with allograft, 1.3% with autologous bone graft, and 8.2% with PEEK. There were no differences in reoperation (p-interaction = 0.59) with rates of 2.64% with TTN, 0% with allograft, 1.69% with autologous bone graft, and 3.3% with PEEK.

Conclusions

This meta-analysis demonstrates that the choice of instrumentation type in the surgical management of spondylodiscitis resulted in no significant differences in rate of radiographic fusion, screw loosening, or reoperation. Future comparative studies to optimize guidelines for the management of spondylodiscitis are needed.
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Metadata
Title
Influence of instrumentation type on outcomes after surgical management of spondylodiscitis: a systematic review and meta-analysis
Authors
Krisna S. Maddy
Joseph Yunga Tigre
Victor M. Lu
Meredith C. Costello
Emily L. Errante
Allan D. Levi
S. Shelby Burks
Publication date
26-12-2023
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-023-08065-w