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Vertebral osteomyelitis (VO) is a disease that responds well to conservative treatment and antibiotherapy if diagnosed in an early stage. Due to the prolonged onset of this pathology, many cases are diagnosed in mid or late stages and require surgery. The surgical treatment is not yet standardized and may only mean decompression of the infectious outbreak without stabilization, or surgical decompression associated with stabilization. Using only bone grafts for surgery or stabilizing the spine through segmental posterior and/or anterior instrumentation is accompanied by many controversies. In this review, we focus on demonstrating that combining a well-conducted antibiotherapy with thorough debridement of the necrotic areas and using metal implants for spinal stabilization lowers the infection rates, provides an early pain-free mobilization of the patient and reduces hospitalization costs.

The impact of vertebral osteomyelitis on spinal stability and principles of surgical stabilization