Posterior debridement and corpectomy via removal of the spinal canal's lateral wall approach for infection after vertebral augmentation: a technique note and early outcome.

Abstract

This study aimed to preliminarily evaluate the efficacy of posterior debridement and corpectomy via the spinal canal's lateral wall approach (PDC-SCLWA) for spinal infection after vertebral augmentation (SIAVA). The procedure is characterized as "lateral wall resection for access, anterior lesion removal for debridement, and posterior wall preservation for bone graft fusion." This distinguishes it from conventional 360° decompression that involves extensive lamina and facet joint resection. Eight patients who underwent PDC-SCLWA were included. The mean surgical duration was 290.6±59.2 minutes, with an average intraoperative blood loss of 775.0±389.7 mL. Intraoperative dural laceration occurred in two patients. All patients' symptoms were alleviated, and no recurrent infection was observed during follow-up. Seven patients received double titanium meshes, and one received an iliac bone graft. At 3 months postoperatively, the fusion rates of intervertebral bodies and posterolateral laminae were 93.8% (15/16) and 100% (7/7), respectively. SIAVA is a severe postoperative complication, especially in elderly patients with multiple comorbidities. PDC-SCLWA is a safe and effective surgical technique. It provides advantages through posterior wall preservation that minimize spinal cord disruption, maintains mechanical stability, and optimizes the bone graft bed for fusion.