Favourable results with identical clinical outcomes and a high rate of fusion was seen in both groups. The titanium coating appears to have no negative effects on outcome or safety in the short term. A future study to determine the effect of titanium coating is warranted. Cite this article: 2017;99-B:1366-72.

An evidence-based recommendation for a standardized antibiotic therapy of spondylodiscitis has not yet been published. Crucial for conservative therapy is the verification of the causative organism and an appropriate antibiotic therapy. Intravenous antibiotic therapy should be administered for 2-3 weeks and a switched to oral administration for 6-12 weeks is then possible. If an empirical antimicrobial therapy is required a combination of ciprofloxacin and clindamycin, alternatively a combination of cefotaxim and flucloxacillin is recommended. Surgical removal of the infection by extensive debridement with stabilization and filling the resulting bone defect is desirable. Under the perception of a high local dose of antibiotic the defect filling with a mixture of cancellous bone and antibiotic-loaded hydroxyapatite and calcium sulfate is advisable.

The study investigated whether the use of carbon fiber-reinforced PEEK screw material (CF-PEEK) can reduce magnetic resonance imaging (MRI) artifact formation. Two consecutive groups of patients were treated for degenerative spinal disorders of the lumbar spine with dorsal transpedicular spinal fusion. The first group (n = 27) received titanium pedicle screws. The second group (n = 20) received CF-PEEK screws. All patients underwent an MRI assessment within the first four postoperative weeks. For each operated segment, the surface of the artifact-free vertebral body area was calculated as percentage of the total vertebral body. For each implanted segment, the assessability of the spinal canal, the neuroforamina, and the pedicle screws, as well as the surrounding bony and soft-tissue structures was graded from 1 to 5. A mean artifact-free vertebral body area of 48.3 ± 5.0% was found in the in the titanium group and of 67.1 ± 5.6% in the CF-PEEK group (p ≤ 0.01). Assessability of the lumbar spine was significantly improved for CF-PEEK screws (p ≤ 0.01) for all measurements. CF-PEEK pedicle screws exhibit smaller artifact areas on vertebral body surfaces and their surrounding tissues, which improves the radiographic assessability. Hence, CF-PEEK may provide a diagnostic benefit.

Both treatment and fusion techniques (ALIF/PLIF) were able to achieve a significant pain relief and reduced consumption of pain medication postoperatively. The recovery period was similar in both groups, but there were differences regarding the date of return to work, hospitalization, duration of surgery and ODI score. Neither of the two methods could show a definite advantage.

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