1. INTRODUCTION
Since infectious spondylitis usually affects the vertebral bodies and intervertebral disc(s), curettage of those lesions and anterior spinal fusion have been the treatment of choice.1 In the thoracic spine, thoracotomy is the standard approach for this surgical purpose; however, the procedure may exert considerable stress on lung function. Anterior debridement through a posterolateral approach was first described by Capener as “lateral rhachotomy” for tuberculous spondylitis in 1954.2 We also reported good surgical outcomes following a single-stage combination of lateral rhachotomy and posterior spinal fusion using a compression hook system for tuberculous spondylitis.3
Recently, a percutaneous pedicle screw (PPS) system has enabled a minimally invasive but rigid posterior spinal fusion for infectious spondylitis outside the infected lesion.4 PPSs can be inserted in a separate tract from the curettage site of lateral rhachotomy, preventing contamination of the implants. Here, we report a case of thoracic pyogenic spondylitis that was successfully treated with single-stage posterior fixation using PPSs in combination with curettage and autogenous iliac bone grafting of the vertebral bodies with bilateral, separated posterolateral approaches.