Dealing with primary spinal infections in the elderly, especially when they spread to the intervertebral space, presents a major challenge for spinal surgeons. Traditional surgery has a low tolerance and cure rate for elderly patients because of the significant trauma it inflicts.

The initial use of the expanded intervertebral foramen approach for debridement, combined with the implantation of a negative pressure drainage sponge (Vaccum Sealing Drainage, VSD) into the thoracolumbar space for treating primary spinal infection, aims to enhance the surgical success rate through staged minimally invasive procedures and to decrease the recurrence rate through closed negative pressure drainage treatment. From June 2018, to November 2022, our hospital treated a total of 11 patients with thoracolumbar infection using VSD. None of these patients had spinal deformities or involvement of intervertebral spaces. After the surgery, make sure to monitor and observethe functional scores of the patient.

All 11 patients achieved clinical cure during the 3-month follow-up after surgery, with no surgical-related deaths. However, one patient died of acute cerebral infarction 5 months after surgery, while the remaining 10 patients completed 12 months of follow-up. After receiving VSD treatment, all patients demonstrated a significant improvement in JOA scores, and there were no recurrences at the last follow-up.

The combination of expanding the intervertebral foramen approach for debridement with VSD treatment has been found to be both feasible and safe for treating primary thoracolumbar vertebral infection in elderly patients. The short-term follow-up results have shown clear effectiveness.