Interbody fusion devices in infections

The initial treatment of disc space and vertebral body infections consists of antibiotics and bedrest. The indications for surgery are the failure of medical management that may include neurologic deficit, epidural abscess, progressive deformity, spinal instability, or intractable pain. The surgical approach must be tailored to directly address the anatomic focus of an infectious process. The general principles of aggressive debridement, drainage of an epidural abscess, correction of spinal deformity, and spinal reconstruction must be followed. This chapter reviews the pathophysiology of spinal infections and the principles of conservative and operative management, particularly involving spinal reconstruction of disc and vertebral defects utilizing implants.