Osteomyelitis of the Spine

Collert, S

doi:10.3109/17453677708988770

Cited by 85 publications

(50 citation statements)

References 11 publications

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“…S. aureus is the predominant pathogen, occurring in 28% of all positive cultures in our Centre, similar to that reported in the current literature [19][20][21]. Pseudomonas aeruginosa is an uncommon cause of spondylodiscitis.…”

Section: Discussionsupporting

confidence: 77%

“…Diabetes mellitus was the most common disease occurring in 18 patients (16.6%) followed by ten (9.25%) end-stage renal disease. Other large series have also substantiated the role of diabetes mellitus as a risk factor for the development of spinal infections [19][20][21]. Systemic illness and infections at other sites were also associated with spontaneous disc space infections One or more comorbid diseases were present in 56 (51.8%) of 108 patients.…”

Section: Discussionmentioning

confidence: 99%

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Management of infectious discitis. Outcome in one hundred and eight patients in a University Hospital

Parra

Martín

Urda

et al. 2012

International Orthopaedics (SICOT)

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Purpose The optimal management of pyogenic discitis is not agreed on. We conducted a retrospective, cross-sectional, observational study in which all patients with discitis who attended Hospital San Carlos Madrid from January 1999 to January 2009 were included. Methods We identified 108 consecutive adult patients with infectious discitis. There were 49 men and 59 women with an average age of 67,5 (+/-16,89) years in the study group. Mean follow-up interval was 6,06 (12,5-2) years. 78 patients had spontaneous discitis and 30 patients had postoperative discitis. Inclusion criteria for the review were illness compatible with vertebral infection and / or evidence of spinal involvement on magnetic resonance imaging (MRI). Results In 56 percutaneous discal biopsy (52% patients) were positive in 28 cases. A single disc was infected in 100 patients. The segments involved were the cervical spine in four, the thoracic spine in 38 and the lumbar spine in 66. One or more comorbid diseases were present in 73 (68%) of 108 patients. Diabetes mellitus was the most common disease. Comorbid disease was rapidly fatal in four patients, ultimately fatal in seven patients, and nonfatal or not present in 97 patients (90 %). Conclusion Early diagnosis is a major challenge. Heightened awareness and the prompt use of MRI are necessary to avoid diagnostic delay. Prolonged antimicrobial therapy and the judicious application of timely surgical intervention are essential for an optimal outcome. Introduction and epidemiology

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Management of infectious discitis. Outcome in one hundred and eight patients in a University Hospital

Parra

Martín

Urda

et al. 2012

International Orthopaedics (SICOT)

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“…Furthermore the operation gives a chance to correct any emerging deformity. Neurological deficiencies [7,10,27,30,39,52], intraspinal abscess [39,52], complete destruction of the vertebral body with spinal deformity [27,39] or inability to rule out a tumorous lesion with imaging techniques or bioptically [12,20,37,58] are regarded as urgent indications for an operative procedure.…”

Section: Abstract Spondylodiscitisoperative Therapy • Anterior Instrmentioning

confidence: 99%

Primary stable anterior instrumentation or dorsoventral spondylodesis in spondylodiscitis?

Eysel¹,

Hopf²,

Vogel³

et al. 1997

Eur Spine J

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The operative results of 23 patients with a specific or unspecific spondylodiscitis were documented over 2 years after the focus of the inflammation had been eradicated, bone chip had been interposed and a CDH instrumentation had been performed by an anterior approach only. These outcomes were compared with the results of 32 patients in whom the focus had been removed and the defect had been filled with bone graft from an anterior approach, followed by stabilisation with CD instrumentation through an additional dorsal approach. In the cases where CDH instrumentation was applied, the range of fusion averaged 1.3 segments. This was clearly less extensive than in dorsoventral stabilisation, in which on average 3.5 segments were fused. In 47 of 55 cases mobilisation was achieved without orthesis. Eight months after the operations bony fusion could be observed radiologically in all patients. The mean preoperative kyphotic angle of the affected segments was 14.4 ° , compared to 4 ° after the operation. The mean loss of reposition was measured to be about 2.7 ° in both groups. Average operation time and blood loss were about 50% higher in the patients treated dorsoventrally. We conclude that even in the case of florid spondylodiscitis, a short-range anterior fusion of the affected spinal segment may be performed by use of a stableangle implant without an increased risk of infection-related loosening.

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“…Spinal infection is a relatively rare condition and accounts for [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].7% of all cases of osteomyelitis [6,11,14,19]. In developed countries, improved public hygiene reduced the incidence of spinal infections in the 1970s; however, several papers [2,3,7,19] have warned that spinal infections have been more frequent recently with the increase of immunocompromised hosts, human immunodeficiency virus (HIV) infection and immigrants from developing countries.…”

Section: Introductionmentioning

confidence: 99%

Recent trends in spinal infections: retrospective analysis of patients treated during the past 50 years

Nagashima

Yamane

Nishi

et al. 2009

International Orthopaedics (SICOT)

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We retrospectively reviewed the medical charts of 210 consecutive patients treated for spinal infection in Tottori University Hospital in Japan between 1956 and 2005. Until 1995, spinal infection was under control in this series; however, during the last decade, it has been on the rise. Male predominance had been gradually progressing, and 69% of the patients were male during the last decade. Patients with spinal infection were aging, and the ratio of immunocompromised hosts dramatically increased to 53%. Until 1995, the percentage of patients with tuberculous spondylitis had been declining; however, the incidence has been on the rise during the last ten years. The organism was detected in 64% of patients treated between 1996 and 2005, of which Staphylococcus aureus was detected in 49%. Moreover, methicillin-resistant S. aureus was detected in 61% of patients with S. aureus. There were no immigrants or cases with human immunodeficiency virus in this series.

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Osteomyelitis of the Spine

Cited by 85 publications

References 11 publications

Management of infectious discitis. Outcome in one hundred and eight patients in a University Hospital

Management of infectious discitis. Outcome in one hundred and eight patients in a University Hospital

Primary stable anterior instrumentation or dorsoventral spondylodesis in spondylodiscitis?

Recent trends in spinal infections: retrospective analysis of patients treated during the past 50 years

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