Simultaneous Oblique Lateral Interbody Fusion (OLIF) and posterior transpedicular screw fixation in treatment of lumbar pyogenic spondylodiscitis

Anterior retroperitoneal spine surgery is advocated for the management of lumbar pyogenic spondylodiscitis (LPS) to target the anterior spondylodiscal pathology. The OLIF corridor provides access to the anterior infective lumbar lesion directly through the pre-psoas space with minimal complications and morbidity, successful debridement, and fusion rate, while respecting surgeon preference, accounting for equipment availability, and the learning curve. The aim of this study was to analyze the clinical, radiological, and functional outcomes after combined OLIF and posterior transpedicular screw fixation in the treatment of LPS. This was a retrospective single-center clinical study. Twenty-seven patients with complicated LPS were treated surgically by combined OLIF and posterior percutaneous transpedicular screw fixation from 2018 to 2021. Preoperatively and postoperatively, all patients were examined clinically for back or leg pain by applying the Visual Analog Scale (VAS), sensory or motor deficit, Arabic-validated Oswestry Disability Index (ODI), and modified Prolo scores; radiologically (plain X-ray, multidetector computerized tomography (MDCT), and magnetic resonance imaging (MRI)). Perioperative data and complications were recorded. All patients were regularly followed for 26 months regarding clinical outcomes, functional status, and radiological measures. Significant postoperative improvement in VAS for back and leg pain, ODI, and modified Prolo scores was reported, with statistically significant differences between preoperative, during, and at the final follow-up. The mean fusion time was 10.52 ± 1.24 months. Twenty-five patients (92.6%) showed definitive fusion (grade 5) according to Lee and Suh’s criteria. This combined surgery is an effective method for treating LPS with adequate canal decompression, radiological correction, and functional recovery.