Minimally Invasive Surgery as a Viable Treatment Alternative for Spondylodiscitis in Patients With Neurologic Deficit: A Comprehensive Literature Review.

Pyogenic spondylodiscitis is a severe infection affecting the spine, characterized by inflammation of the intervertebral disc and adjacent vertebrae. It can lead to significant morbidity due to complications like spinal instability and neurological deficits. This literature review examines the current approaches in managing pyogenic spondylodiscitis, focusing on surgical interventions, early detection, and the role of antibiotic therapy. The review highlights that surgical intervention is often required when extensive bony destruction, neural compression, or kyphotic deformity compromises spinal mechanics and function. We performed the review study according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using MeSH terms such as pyogenic spondylodiscitis, spinal instability, epidural abscess, neurological deficits, surgical intervention, and early decompression through various search machines such as PubMed-NCBI, Web of Science, Cochrane Library, Scopus, and Embase. Initially, 176 studies were identified in a primary search for screening. After excluding papers that did not fulfill the inclusion criteria, 50 studies were included. Neurological deficits are common and often result from epidural abscesses, which necessitate timely surgical decompression to prevent permanent damage. Delays in treatment can worsen the condition, requiring emergency interventions to address abscesses and prevent progressive disability. This review aims to analyze and understand whether the minimally invasive surgery (MIS) approach can be as sufficient as the open surgical approach in treating spondylodiscitis with neurologic deficit and to evaluate the quality of the outcome.