Infectious spondylodiscitis: A twenty-year experience from a single tertiary referral center

Feki, A.; Akrout, R.; Masmoudi, Karim; Sellami, I.; Ezzeddine, M.; Mnejja, Mohamed Amine; Hentati, Yosr; Fourati, H.; Baklouti, S.

doi:10.1016/j.ejr.2018.07.006

Cited by 5 publications

(6 citation statements)

References 33 publications

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“…En el caso de la espondilodiscitis tuberculosa, los procedimientos mínimamente invasivos descritos son : la limpieza quirúrgica a través de un abordaje transforaminal endoscópico percutáneo para espondilitis tuberculosa con absceso de psoas (15), la discectomía percutánea con curetaje del disco intervertebral infectado seguido de irrigación continua (16) y el muestreo guiado por tomografía computarizada, un método utilizado en pacientes con espondilodiscitis y hemocultivos negativos, con un rendimiento del 31-91% para la detección del agente infeccioso y que puede ser utilizado en la columna cervical, dorsal y lumbar (17). Asimismo, el Mycobacterium tuberculosis fue el agente más aislado en un estudio que utilizó biopsia percutánea de disco guiado por tomografía computarizada (18).…”

Section: Discussionunclassified

Abordaje transforaminal percutáneo para el diagnóstico y tratamiento de un caso de espondilodiscitis tuberculosa lumbar con absceso epidural.

et al. 2022

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La enfermedad de Pott o espondilodiscitis tuberculosa representa menos del 1% de los casos de tuberculosis. Sin embargo, el curso clínico indolente de esta enfermedad hace que su diagnóstico sea generalmente tardío, causando con ello la destrucción de las estructuras vertebrales. La deformidad resultante de la columna vertebral requiere tratamiento quirúrgico, el cual es complejo y requiere una estancia hospitalaria prolongada. Se describe el caso de un paciente varón de 52 años que fue diagnosticado de espondilodiscitis lumbar luego de la correspondiente evaluación clínica y estudios imagenológicos sin mostrar respuesta al tratamiento antibiótico empírico. Un abordaje transforaminal percutáneo, técnica mínimamente invasiva, permitió el diagnóstico de espondilodiscitis tuberculosa y la mejoría sintomática del paciente.

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Section: Discussionunclassified

Abordaje transforaminal percutáneo para el diagnóstico y tratamiento de un caso de espondilodiscitis tuberculosa lumbar con absceso epidural.

et al. 2022

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“…Though Staphylococcus aureus and Mycobacterium tuberculosis are common pathogens causing spondylodiscitis, infections due to Salmonella have also been described. [ 5 6 11 12 13 14 ] Salmonella vertebral osteomyelitis may have been underdiagnosed, as imaging-guided/open surgical biopsy is required to confirm the diagnosis. In the absence of microbiological diagnosis, many patients may have been treated with empirical therapy directed against Mycobacteria or gram-positive organisms.…”

Section: Discussionmentioning

confidence: 99%

Case report of infective spondylodiscitis due to nalidixic acid-resistant Salmonella paratyphi A

Das

Bandyopadhyay

Hansdak

2021

Journal of Family Medicine and Primary Care

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Spondylodiscitis due to typhoidal Salmonella presents a therapeutic challenge for clinicians. Factors that complicate treatment include drug-resistant strains, poor antibiotic bone penetration, potential for neurological compromise and lack of established protocols and guidelines. We discuss a 57-year-old man with Salmonella paratyphi A spondylodiscitis involving lower thoracic vertebrae and discuss various aspects of management.

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“…Спондилодисцит -це гнійний остеомієліт хребта, який визначається інфекційним процесом, що починається з ураження замикальних пластин, супроводжується деструкцією тіл хребців, вторинним втягненням міжхребцевого диску та поширенням на паравертебральні м'які тканини й епідуральний простір [1][2].…”

Section: вступunclassified

“…Spondylodiscitis is pyogenic vertebral osteomyelitis, which is characterized by an infectious process beginning with erosion of endplates, accompanied by the destruction of vertebral bodies, secondary retraction of the intervertebral disc and extension to the paravertebral soft tissues and epidural space [1,2].…”

Section: Introductionmentioning

confidence: 99%

Early Imaging and Course-of-Disease Control Markers of Pyogenic Vertebral Osteomyelitis

Bohdan¹,

Plakhtyr²,

Bohdan³

2021

PSSS MS

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Background. The diagnosis of early pyogenic vertebral osteomyelitis is essential for prompt determination of treatment strategy and prevention of suppurative-destructive complications, although the nonspecifi c clinical manifestation obstructs timely disease detection. Aim. To analyse the clinical accuracy of various radiological imaging methods for early detection and control over vertebral osteomyelitis course Materials and methods. A retrospective study of standardized clinical data of patients (N = 54) who underwent treatment at the Neurosurgery Department of the MМCC WR between 2010 and 2020 was carried out. Patients were observed for 12–36 months. Study fi ndings and discussion. Our study revealed that during radiological imaging, infl ammatory changes in the vertebrae specifi c to osteomyelitis were not found in any case, which signifi cantly delays the diagnosis. The study analysed and grouped radiological signs of the infl ammatory process spread in the vertebrae in case of spondylodiscitis by CT and MR stages. Spondylodiscitis was diagnosed by CT of the spine in the late third stage only in 29.0 % of patients. Nonspecifi c destructive changes of vertebrae were detected in 51.6% of persons, which required additional MRI examination to establish the diagnosis. In 19.4% of those examined in the presence of the fi rst MR stage, no specifi c CT signs of osteomyelitis were found. MRI scan of the spine is the main specifi c (93 %), accurate (94 %) and sensitive (97 %) method for early detection of pyogenic osteomyelitis. Although according to the world literature, MRI is not sensitive enough to assess the dynamics of the infl ammatory process in the spine, the progressive increase in signal intensity of vertebral cortex on T1-weighted images within aff ected vertebrae correlates well with infl ammation resolving and C-reactive protein (CRP) level normalization. We described this radiological sign as a «vertebral rim» phenomenon (VRP). In our study, a reliable correlation was found between CRP level and the «vertebral rim» phenomenon on MRI. Conclusions. For early detection of pyogenic vertebral osteomyelitis, MRI examination is the main specifi c and sensitive method. We suggest combining the CRP level and «vertebral rim» sign in practice as dynamics of spondylodiscitis markers and justifi cation of antibacterial therapy strategy.

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Infectious spondylodiscitis: A twenty-year experience from a single tertiary referral center

Cited by 5 publications

References 33 publications

Abordaje transforaminal percutáneo para el diagnóstico y tratamiento de un caso de espondilodiscitis tuberculosa lumbar con absceso epidural.

Abordaje transforaminal percutáneo para el diagnóstico y tratamiento de un caso de espondilodiscitis tuberculosa lumbar con absceso epidural.

Case report of infective spondylodiscitis due to nalidixic acid-resistant Salmonella paratyphi A

Early Imaging and Course-of-Disease Control Markers of Pyogenic Vertebral Osteomyelitis

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