Spondylitis and spondylodiscitis

Spondylodiscitis in the elderly patient: clinical mid-term results and quality of life

“…The pathogen most frequently identiWed in our study was Staphylococcus aureus, in 50% of cases and we, therefore, did not see a shift to gram negative. This value corresponds to the age-independent data found in the literature (30-80%) [28,30].…”

“…Abscesses were present in 68.8% of cases, epidural abscesses in 37.5%, neurologic deWcits in 25.9% and pathologic reXexes in 45.0%. Other publications examining the disease without age selection have reported lower extremity paresis in 11-29% of patients and acute decline in health status of 13-26% [2,13,28].…”

“…The incidence of pyogenic spondylodiscitis is about 1:250,000 corresponding to about 3-5% of all cases of osteomyelitis. Men are up to three times more often aVected than women [2,17,21,26,28,30,33]. The frequency of spondylodiscitis after lumbar disc operations depends on the invasiveness of the operation and is given as between 0.1 and 0.6% for microsurgical operations and from 1.4 to 3% for macrosurgical operations [10,14,22]; 10-15% of all vertebral infections can be ascribed to exogenous spondylodiscitis [2,9,17].…”

“…The frequency of spondylodiscitis after lumbar disc operations depends on the invasiveness of the operation and is given as between 0.1 and 0.6% for microsurgical operations and from 1.4 to 3% for macrosurgical operations [10,14,22]; 10-15% of all vertebral infections can be ascribed to exogenous spondylodiscitis [2,9,17]. Predisposing factors include age, multi-morbidity, diabetes mellitus, cardiovascular diseases, obesity, renal failure, chronic hepatitis, rheumatic diseases, chronic steroid intake, cancer, administration of immunosuppressives, preceding systemic diseases, old tuberculosis, prior visceral operations, sickle cell anaemia, drug abuse and HIV [2,21,26,28,30,31].…”

“…In older patients, there is often a long history of back pain, with multiple therapies that fail to reduce symptoms. The literature reports an average period of 2-6 months between Wrst occurrence of symptoms and the diagnosis of spondylodiscitis [2,19,21,26,28,30].…”