الفهرس 
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Abstract
Our present study was conducted in the department of Orthopedics and traumatology, sohag university hospital, Sohag University during the period between January 2015 and January 2016. Fifteen patients with spondylodiscitis at thoracolumbar spine managed operatively with surgical debridement, decompression & fixation during the course of the study were sorted and each was followed for at least 6 months.
Follow up of all patients were carried out regularly with clinical, neurological and radiological assessment till 12 months postoperatively.
The data thus collected from patients was analyzed, evaluated, and the observations were recorded.
Our aim was to evaluate the result of surgical management of patients with thoracolumbar spondylodiscitis.
All the patients were examined clinically, neurologically and radiological, including detail history of pre morbid status at the time of admission. Patients fulfilling the inclusion criteria was only included in the study.
Mean age in years was 50. There was a male preponderance in our patients.
A male to female ratio in all patients was about 1.5:1.
Most common mode of infection was haematogenous spread (80%),post spine surgery (20%) of cases.The most common pathogen was non specific(53%), followed by T.B(33%).
In this study, The lumbar spine was the most common site of spondylodiscitis (9 cases), followed by the thoracic spine (3 cases). There were (3 cases) that involved the thoracolumbar spines.
In present study series about (73.3%) of the patients had associated iillness. Most of them have D.M in 5cases (33%) ,chronic renal disease in (6%), immunosuppression in 12% & in 20% of cases they have undergone previous spinal surgery .
Most of the patients were operated at elective operation list within 7-10 days of admission in the hospital (75%).
While the rest of the patients (25%) operative procedure was delayed either due to medical problem or due to financial constrains.
Majority of patients in present study series were neurologically affected in 9 cases (60%) as four patients were classified as Frankel type C, three as Frankel type D & two cases as Frankle B.
After surgery, the neurological status changed in patients as two patients was Frankle C &two patients Frankle D changed to Frankle E & two patients was Frankle B changed to Frankle D & one patient changed from Frankle C to Frankle D.
Preoperatively; 2 patients were found to have immuno suppression, 5 patients were found to have diabetes mellitus, chronic renal disease in 1 case, ischemic heart disease was in 3 patients and Stress hypertension noted in many patients.
Superficial would infection was seen in two cases. they were female patients, diabetic and was obese. No deaths ocured.
Surgical debridement, decompression & transpedicular fixation was done in all patients.
In our study series, according to modified Oswestry Low Back Pain Disability system there were 9 cases with Minimal disability about (60%); they can cope with most living activities, 5 cases (33%) with moderate disability and the back condition can usually be managed by conservative means, 1cases (6%) with sever disability and strong analgesics was needed
Two cases (12%) had superficial infection managed within 1 week and one case (6%) had dural tear.
Angle of kyphosis was measured by Cobb method preoperatively and at the last visit.
Mean kyphotic angle preoperative was = 19.50 and post operative mean angle =10.150.
mean follow up period was 8.55+_3.38 ranging (2-12 ms).
CONCLUSION
Spondylodiscitis remains rare but its incidence is rising, due to an increasingly susceptib e population and the availability of more effective diagnostic tools.
A high index of suspicion is needed for prompt diagnosis to ensure improved long-term outcomes.
MRI is the gold standard tool for diagnosing spondylodiscitis. Surgery has an important role in alleviating pain, correcting deformities and neural compromise and restoring function. Surgical debridement , decompression & stabilization is very effective in management of spondylodiscitis followed by tissue culture & sensitivity to ensure diagnosis & choice of appropriate antibiotic.