Cervical spine spondylodiscitis: Review of literature on current treatment strategies

Treffy, Randall W.; Laing, Brandon; Eraky, Akram M.; Shabani, Saman

doi:10.1016/j.heliyon.2023.e17875

Cited by 5 publications

(3 citation statements)

References 65 publications

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“…Cervical spondylodiscitis is a rare pathology, with an incidence of 0.5–2.5 per 100,000 population ( 1 ). It appears to be particularly dangerous as it has a higher potential for permanent neurological damage compared to thoracolumbar spondylodiscitis ( 2 ). The mortality rate in individual case series varied between 5% and 10% ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical and surgical outcome in patients with cervical spondylodiscitis—a single-center retrospective case series of 24 patients

Motov,

Stemmer,

Krauss

et al. 2024

Front. Surg.

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ObjectiveCervical spondylodiscitis is a rare pathology, with an incidence of 0.5–2.5 per 100,000 population, posing significant potential risks. This type of infection can lead to neurological impairment in up to 29% of patients. Radical surgical debridement of the infected segment, fusion, and an intravenous antibiotic regimen remains the gold standard in most spine centers. This study aimed to analyze the surgical outcome in a tertiary spine center based on disease severity.MethodsIn this study, we retrospectively included all patients diagnosed with cervical spondylodiscitis and treated at the University Hospital Augsburg between January 2017 and May 2022. We collected and analyzed baseline parameters on clinical presentation with symptoms, laboratory parameters, radiological appearance, and surgical parameters such as type of approach and implant, as well as neurological and radiological outcomes. Descriptive statistics were performed using SPSS, and relevant correlations were examined using the t-test for independent samples and the chi-square test.ResultsTwenty-four patients (9%) with cervical spondylodiscitis were identified. Twenty-two (92%) surgically treated patients were subdivided into the complicated discitis group (n = 14, 64%) and the uncomplicated discitis group (n = 8, 36%). Seventeen patients (71%) presented with sepsis on admission, 17 patients (71%) were diagnosed with epidural abscess on primary imaging, and 5 patients (21%) had more than one discitis lesion at a distant spinal segment. The presence of epidural abscess was significantly associated with systemic sepsis (OR = 6.2; p = 0.03) and myelopathy symptoms (OR = 14.4; p = 0.00). The most frequently detected specimen was a multisensitive Staphylococcus aureus (10 patients, 42%). Six patients (25%) died after a median of 20 days despite antibiogram-accurate therapy, five of whom were diagnosed with a complicated type of discitis. The follow-up data of 15 patients (63%) revealed permanent neurological damage in 9 patients (38%). Notably, the surgical approach was a significant factor for revision surgery (p = 0.008), as three out of five (60%) ventrodorsal cases with complicated discitis were revised.ConclusionCervical spondylodiscitis represents a severe infectious disease that is often associated with permanent neurological damage or a fatal outcome, despite adequate surgical and antibiotic treatments. Complicated types of discitis may require a more challenging surgical and clinical course.

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Section: Introductionmentioning

confidence: 99%

Clinical and surgical outcome in patients with cervical spondylodiscitis—a single-center retrospective case series of 24 patients

Motov,

Stemmer,

Krauss

et al. 2024

Front. Surg.

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“…Spondylodiscitis is an ever increasing health concern as more patients are diagnosed each year. 1,2 Despite the increased incidence, diagnosis is often delayed in many of these patients leading to potential significant deformity and secondary neurological deficits, sometimes requiring extensive surgical intervention. 2-7 Here, we present a case in which a patient had significant thoracic kyphosis due to spondylodiscitis leading to destruction of the T8 vertebral body as well as the inferior endplate of T7 and superior endplate of T9 with preservation of the posterior elements.…”

mentioning

confidence: 99%

“…1,2 Despite the increased incidence, diagnosis is often delayed in many of these patients leading to potential significant deformity and secondary neurological deficits, sometimes requiring extensive surgical intervention. 2-7 Here, we present a case in which a patient had significant thoracic kyphosis due to spondylodiscitis leading to destruction of the T8 vertebral body as well as the inferior endplate of T7 and superior endplate of T9 with preservation of the posterior elements. This deformity is technically challenging to correct; therefore, we used the rail technique, similar to techniques used for posterior column subtraction, 8 but instead modified to restore the height lost from the destruction of the T8 vertebral body.…”

mentioning

confidence: 99%

Use of “Rail Technique” to Correct Thoracic Kyphosis: 2-Dimensional Operative Video

Treffy,

Hussain,

Shabani

2023

Operative Neurosurgery

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Spondylodiscitis is an ever increasing health concern as more patients are diagnosed each year. 1,2 Despite the increased incidence, diagnosis is often delayed in many of these patients leading to potential significant deformity and secondary neurological deficits, sometimes requiring extensive surgical intervention. [2][3][4][5][6][7] Here, we present a case in which a patient had significant thoracic kyphosis due to spondylodiscitis leading to destruction of the T8 vertebral body as well as the inferior endplate of T7 and superior endplate of T9 with preservation of the posterior elements. This deformity is technically challenging to correct; therefore, we used the rail technique, similar to techniques used for posterior column subtraction, 8 but instead modified to restore the height lost from the destruction of the T8 vertebral body. This allowed us to then perform a retropleural approach to a T7-T9 corpectomy with expandable cage to complete a 360°fusion construct. The patient depicted in the video consented to the procedure as well as for images and videos from their operation to be included in educational material.

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An uncommon cause of retropharyngeal abscess in adults: Cervical pyogenic spondylodiscitis

Bouatay,

Belhadj Miled,

Koubaa

2024

International Journal of Surgery Case Reports

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Cervical spine spondylodiscitis: Review of literature on current treatment strategies

Cited by 5 publications

References 65 publications

Clinical and surgical outcome in patients with cervical spondylodiscitis—a single-center retrospective case series of 24 patients

Clinical and surgical outcome in patients with cervical spondylodiscitis—a single-center retrospective case series of 24 patients

Use of “Rail Technique” to Correct Thoracic Kyphosis: 2-Dimensional Operative Video

An uncommon cause of retropharyngeal abscess in adults: Cervical pyogenic spondylodiscitis

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