Fungal spondylodiscitis is rare (0.5%-1.6% of spondylodiscitis) and mainly caused by Candida albicans. Surgical intervention in spondylodiscitis patients is indicated for compression of neural elements, spinal instability, severe kyphosis, failure of conservative management and intractable pain. However, there is no evidence-based optimal surgical approach for spondylodiscitis. There have been only case reports of surgical treatment for Candida spondylodiscitis. We evaluated the preliminary results of the efficacy and safety of one-stage debridement via oblique lateral corridor with interbody fusion (OLIF) using stand-alone cement reconstruction after debridement for the treatment of Candida spondylodiscitis in patients with major co-morbidities. Five patients (4 males, 1 female, mean age: 64.2 years) suffering from Candida albicans lumbar spondylodiscitis who underwent this procedure were studied. Their predominant symptoms were unremitting back and leg pain and all had pre and post-operative anti-fungal therapy under microbiologist supervision. The operative time ranged from 137 minutes to 260 minutes (mean: 213.4 minutes). The mean blood loss was 160ml (range: 100-200 ml). There were no peri-operative complications. At follow-up all showed major improvement in pain and ambulatory status. CT scan showed radiological stability for all patients at 6-12 months. Our preliminary results showed stand-alone anterior debridement and spinal re-construction with cement through mini-open OLIF approach is a safe and effective option for patients with spinal fungal infection and major comorbidities.Le texte complet de cet article est disponible en PDF.
Keywords : Candida spondylodiscitis, fungal spinal infection, oblique lateral corridor, interbody fusion, OLIF, cement reconstruction, debridement