Infections of the Spine

Kim, Choll W.; Currier, Bradford L.; Eismont, Frank J.

doi:10.1016/b978-1-4160-6726-9.00086-9

Cited by 5 publications

(5 citation statements)

References 417 publications

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“…In order to get enough tissue more accurately from the pathologic area, percutaneous CT-guided needle biopsy is a good option to enhance the culture result 6 , 10 , 25) . The most common isolated etiologic microorganism causing PSI in this study is Staphylococcus aureus followed by E. coli , like in most of the reports 1 , 7 , 15 , 16 , 21 , 22 , 24 , 27 , 29) .…”

Section: Discussionsupporting

confidence: 59%

“…In 2001, Park and Kim 24) reported that 13 patients of the 19 spondylitis patients who had been managed surgically were diagnosed as tuberculous spine infection. However, the incidence of TSI tends to decrease owing to vaccination of tuberculosis and anti-tuberculosis medication and the incidence of PSI seems to rise as results from increase of spinal procedures or surgeries and misuse of antibiotics 12 , 16 , 27) . Recently, in 2010, Kim et al 15) reported pyogenic spondylodiscitis (62.7%) is more frequent than tuberculous spondylodiscitis (37.3%).…”

Section: Discussionmentioning

confidence: 99%

“…There is consensus that the most common lesion of pyogenic spinal infection is lumbar spine 1 , 7 , 15 , 16 , 21 , 29) . According to the studies about tuberculous spinal infection, the frequency of involvement varies widely, with the peak levels being at the thoracolumbar junction and with decreasing frequencies at more rostral and caudal levels 27) .…”

Section: Discussionmentioning

confidence: 99%

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Microbiology and Epidemiology of Infectious Spinal Disease

Jeong

Choi

Youm

et al. 2014

J Korean Neurosurg Soc

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ObjectiveInfectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes.MethodsA retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05.ResultsNinety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases.ConclusionMany previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Microbiology and Epidemiology of Infectious Spinal Disease

Jeong

Choi

Youm

et al. 2014

J Korean Neurosurg Soc

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“…18 The mainstay of treatment is still ATT. 19 Although statistically not significant, younger patients presented with pathologies in the subaxial or cervicothoracic areas. All patients with SACTB were >10 years old and this is due to the vertical orientation of facet joints reducing upper cervical mobility and increasing subaxial cervical mobility.…”

Section: Ethical Considerationmentioning

confidence: 84%

Treatment Outcomes among Pediatric Patients with Cervical Pott’s Disease in a Tertiary Care Center: A Case Series

Caro,

Dizon

2023

PJO

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Tuberculosis remains a perennial global problem despite advances in detection and treatment. Apart from the pulmonary system, it can also affect the spine of both adult and pediatric patients, with a predilection for the thoracic and lumbar spine. Rarely does spinal TB or Pott's disease affect the cervical spine and there are few highlevel studies in the pediatric population.Variations are the following: Atlantoaxial/Upper Cervical TB (AATB), Subaxial Cervical TB (SACTB), and Cervicothoracic TB (CTTB). Motor and sensory deficits are more common in CTTB and some SACTB patients while myelopathic signs predominate in AATB patients. The mainstay of treatment for pediatric cervical TB is still anti-tubercular treatment (ATT) using anti-Koch's medication depending on the level of drug resistance. For some patients, surgery may be indicated with CTTB having the lowest threshold because of its anatomic location. Most patients improve after a year of treatment with at least a 1 Frankel letter grade improvement.

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“…2023; 52 (5): 545-547 Introducción L a espondilodiscitis infecciosa, espondilitis u osteomielitis vertebral es una patología de baja incidencia, aunque ésta ha aumentado en los últimos años debido a un mayor número de procedimientos quirúrgicos espinales, de bacteriemia nosocomial, el envejecimiento de la población y la adicción a drogas por vía parenteral. La infección hematógena sigue siendo la causa más común de espondilitis [1], [2]. La infección producida por Staphylococcus aureus es la forma más frecuente de enfermedad, aunque la tuberculosis y la brucelosis son todavía etiologías frecuentes [3].…”

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Espondilodiscitis infecciosa Caso clínico

Mora-Aznar,

Moreno-Hijazo

2023

Rev. chil. anest.

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Objetivos: Análisis de un caso de espondilodiscitis infecciosa con retraso en su diagnóstico que deriva en un shock distributivo de difícil manejo. Estudio de los diagnósticos diferenciales y revisión bibliográfica. Material y Métodos: Presentación de un caso clínico sobre la espondilodiscitis infecciosa de una paciente que precisó ingreso en la Unidad del Paciente Crítico de un Hospital de Segundo Nivel en España. Para ello, se obtuvo consentimiento expreso por parte del paciente, así como del Comité de Ética de nuestro Centro. Resultados: Revisión de la historia clínica y actual de una mujer de avanzada edad que acude a nuestro centro hospitalario por lumbalgia sin etiología filiada, evolución rápida y tórpida hacia un cuadro de shock distributivo, que plantea distintos diagnósticos diferenciales, encontrando finalmente el diagnóstico acertado mediante pruebas complementarias específicas, pudiendo instaurar un tratamiento orientado, inicialmente conservador y después quirúrgico con correcta evolución posterior. Conclusiones: La espondilodiscitis infecciosa es una entidad infecciosa cuya incidencia ha aumentado en los últimos años debido a una mayor esperanza de vida de pacientes con enfermedades crónicas que suponen condiciones para cierto grado de inmunodeficiencia. Se han descrito casos con espondilodiscitis en los que se debe evaluar la coexistencia de endocarditis infecciosa, como es el caso que hemos planteado, así como valorar la indicación de intervención quirúrgica en casos sin respuesta a terapia antimicrobiana como es la paciente que nos ocupa.

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Infections of the Spine

Cited by 5 publications

References 417 publications

Microbiology and Epidemiology of Infectious Spinal Disease

Microbiology and Epidemiology of Infectious Spinal Disease

Treatment Outcomes among Pediatric Patients with Cervical Pott’s Disease in a Tertiary Care Center: A Case Series

Espondilodiscitis infecciosa Caso clínico

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