Brace treatment results of thoracolumbar vertebral osteomyelitis

Tunis Med. 2023 May 5;101(5):515-520.
[Article in French]

Abstract

Introduction: Vertebral osteomyelitis is a destructive affection for disc and vertebral body leading 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 measured.

Results: The mean age was 54. Koch bacillus was the identified in 19 cases. Vertebral compression rate was significantly higher in thoracic localization 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 stabilized 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 localizations. In vertebral osteomyelitis, brace immobilization was more effective in lombar than thoracic localizations and in patients up to 70 Kg in weight.

Publication types

  • English Abstract

MeSH terms

  • Fractures, Compression*
  • Humans
  • Kyphosis* / complications
  • Lordosis* / etiology
  • Middle Aged
  • Retrospective Studies
  • Scoliosis* / complications
  • Scoliosis* / therapy
  • Spine
  • Treatment Outcome