When and how to operate on spondylodiscitis: a report of 13 patients

Mavrogenis, Andreas F.; Igoumenou, Vasilios G.; Tsiavos, Konstantinos; Megaloikonomos, Panayiotis D.; Panagopoulos, Georgios N.; Vottis, Christos; Giannitsioti, Efthymia; Παπαδοπουλοσ, Αντωνιοσ; Soultanis, Konstantinos

doi:10.1007/s00590-015-1674-6

Cited by 30 publications

(27 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indications for surgery include failure of conservative treatment with no resolution of symptoms, septic status, spinal instability, spinal canal abscesses (Figure 4), paravertebral abscess >2.5 cm, and spinal cord or nerve root compression with progressive neurological deficits ( Figure 5, Table 3) [45]. Spinal deformity such as kyphosis or scoliosis can be the end result of a spinal infection that in most cases need also to be addressed surgically [84]. Although in most cases surgical treatment is not needed, almost 50% of patients with spinal infection will undergo some sort of surgery [58].…”

Section: Surgical Managementmentioning

confidence: 99%

Spinal Infections: An Update

et al. 2020

View full text Add to dashboard Cite

Spinal infection poses a demanding diagnostic and treatment problem for which a multidisciplinary approach with spine surgeons, radiologists, and infectious disease specialists is required. Infections are usually caused by bacterial microorganisms, although fungal infections can also occur. The most common route for spinal infection is through hematogenous spread of the microorganism from a distant infected area. Most patients with spinal infections diagnosed in early stages can be successfully managed conservatively with antibiotics, bed rest, and spinal braces. In cases of gross or pending instability, progressive neurological deficits, failure of conservative treatment, spinal abscess formation, severe symptoms indicating sepsis, and failure of previous conservative treatment, surgical treatment is required. In either case, close monitoring of the patients with spinal infection with serial neurological examinations and imaging studies is necessary.

show abstract

Section: Surgical Managementmentioning

confidence: 99%

Spinal Infections: An Update

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Conservative treatment remains the standard of care for most patients, even in cases of advanced involvement of bone or soft tissues at this spinal level 3,11,13; using improved imaging and appropriate antibiotics, the morbidity and mortality of these patients has fallen from 25% to 56% 15 years before, to <5% in the present era 2-6,11,13. Selected cases with extensive bone destruction should be considered for surgical treatment 11.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery should also be reserved for cases where diagnosis is in doubt and there is an initial severe or progressive neurologic deficit with or without respiratory distress, in presence of documented mechanical compression and/or dynamic instability following conservative treatment 3. Moreover, surgical treatment is indicated after failed conservative treatment, in patients with spinal instability, and in those with deteriorating neurological status 6. Some authors proposed immediate surgical intervention, with a single or 2-stage anterior or transoral decompression and posterior spine stabilization 2,3; early surgical intervention provides for tissue sampling for precise diagnosis, spinal decompression and early mobilization 3.…”

Section: Discussionmentioning

confidence: 99%

“…In the modern era, the incidence of tuberculous spondylodiscitis has risen because of the increase of the susceptible population such as the elderly, immunosuppressed or compromised and intravenous drug users, and the low access to health care systems of patients in low social and economic status such as third party migrants, prisoners and long hospitalized 1-6. The incidence of Mycobacterium tuberculosis spondylodiscitis in developed countries ranges from 9% to 46% 7-11.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tuberculous Spondylitis of the Craniovertebral Junction

Megaloikonomos

Igoumenou

Antoniadou

et al. 2016

J. Bone Joint Infect.

Self Cite

View full text Add to dashboard Cite

Craniovertebral junction tuberculosis is rare, accounting for 0.3 to 1% of all tuberculous spondylitis cases. MR imaging is the modality of choice to detect bone involvement, abscess formation and subligamentous spreading of the pus, to differentiate from other lesions affecting the craniovertebral junction, and to determine the efficacy of treatment. Given the fact that surgical treatment of patients with craniovertebral junction tuberculosis has been associated with a high mortality rate ranging up to 10% and recurrence rate ranging up to 20%, conservative is the standard of treatment for most patients.This article presents a patient with craniovertebral junction Mycobacterium tuberculosis infection diagnosed with CT-guided biopsy. A halo vest was applied and antituberculous treatment with rifampicin, isoniazid and ethambutol was initiated. At 6-month follow-up, the patient was asymptomatic; CT of the cervical spine showed healing of the bony lesions. The halo vest was removed and physical therapy was recommended. Antituberculous treatment was continued for a total of 18 months, without any evidence of infection recurrence

show abstract

“…Conservative treatment is the standard of care for spondylitis and is expected to be effective in most of cases 36. Surgical treatment is indicated for patients with spinal cord or cauda equina compression with progressive neurological deficits, and for those with spinal instability due to extensive bone destruction, significant deformity or when conservative treatment fails 37.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Spondylitis transmitted from infected aortic grafts: a review

Megaloikonomos

Antoniadou

Dimopoulos

et al. 2017

J. Bone Joint Infect.

Self Cite

View full text Add to dashboard Cite

Graft infection following aortic aneurysms repair is an uncommon but devastating complication; its incidence ranges from <1% to 6% (mean 4%), with an associated perioperative and overall mortality of 12% and 17.5-20%, respectively. The most common causative organisms are Staphylococcus aureus and Escherichia coli; causative bacteria typically arise from the skin or gastrointestinal tract. The pathogenetic mechanisms of aortic graft infections are mainly breaks in sterile technique during its implantation, superinfection during bacteremia from a variety of sources, severe intraperitoneal or retroperitoneal inflammation, inoculation of bacteria during postoperative percutaneous interventions to manage various types of endoleaks, and external injury of the vascular graft. Mechanical forces in direct relation to the device were implicated in fistula formation in 35% of cases of graft infection. Partial rupture and graft migration leading to gradual erosion of the bowel wall and aortoenteric fistulas have been reported in 30.8% of cases.Rarely, infection via continuous tissues may affect the spine, resulting in spondylitis. Even though graft explantation and surgical debridement is usually the preferred course of action, comorbidities and increased perioperative risk may preclude patients from surgery and endorse a conservative approach as the treatment of choice. In contrast, conservative treatment is the treatment of choice for spondylitis; surgery may be indicated in approximately 8.5% of patients with neural compression or excessive spinal infection. To enhance the literature, we searched the related literature for published studies on continuous spondylitis from infected endovascular grafts aiming to summarize the pathogenesis and diagnosis, and to discuss the treatment and outcome of the patients with these rare and complex infections.

show abstract

When and how to operate on spondylodiscitis: a report of 13 patients

Cited by 30 publications

References 50 publications

Spinal Infections: An Update

Spinal Infections: An Update

Tuberculous Spondylitis of the Craniovertebral Junction

Spondylitis transmitted from infected aortic grafts: a review

Contact Info

Product

Resources

About