Cervical osteomyelitis: a brief review

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>The authors conducted a literature-based review of the etiology, diagnosis, and treatment of cervical vertebral osteomyelitis (CVO).</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A Medline (PubMed) search using the key words “cervical vertebral osteomyelitis” yielded 256 articles. These were further screened for relevance, yielding 15 articles. Each publication was reviewed, and several others not identified in the PubMed search were screened and included in the review according to relevance. Each article was identified as involving either the epidemiology/etiology, diagnosis, or treatment of CVO. Separate categories were created for case reports and general reviews.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Cervical vertebral osteomyelitis has a spectrum of origins, which include spontaneous, postoperative, traumatic, and hematogenously spread causes. The majority of patients have medical risk factors and comorbidities that include diabetes, trauma, drug abuse, and infectious processes in extraspinal areas. The diagnosis of CVO can be accomplished in most cases by using plain x-ray films and computerized tomography scans. Nevertheless, preferential use of magnetic resonance imaging in cases in which there is a neurological deficit is helpful in identifying epidural compressive processes. Treatment for CVO can be successfully initiated with intravenous antibiotic therapy. Nevertheless, in cases in which there is a neurological deficit, spinal deformity and/or progressive lysis, or intractable pain, the earliest feasible surgical intervention with debridement and fusion is warranted.</jats:p></jats:sec>

Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

“…A literature review regarding the treatment of cervical spondylodiscitis had been published previously [48]. In order to obtain an evidence-based assessment of the literature on this subject, this review was performed in adherence to the PRISMA statement and used the GRADE approach.…”

Complex 360°-reconstruction and stabilization of the cervical spine due to osteomyelitis

“…Independently of its origin, cervical osteomyelitis requires surgical intervention in the presence of a neurologic deficit, extensive bony destruction, paravertebral or epidural abscess formation and persistent septicaemia [1,2,12,25]. Anterior debridement and spondylodesis seem to be sufficient in cases without instability and severe deformity [6,10,13], but multisegmental involvement or distinct substance loss requires a combined anterior-posterior approach [10,13,23,24].…”

“…Anterior debridement and spondylodesis seem to be sufficient in cases without instability and severe deformity [6,10,13], but multisegmental involvement or distinct substance loss requires a combined anterior-posterior approach [10,13,23,24]. Most of these reports deal with the thoracic and lumbar spine, but results may be transferred to the cervical spine too [1,2,10,24].…”

“…Osteomyelitis of the cervical spine is a rare event representing 3-6% of vertebral osteomyelitis [1,2,25]. It is mainly caused by haematogenous spread [1,2,5,25,28], but may also occur as a complication of operative procedures [1,2,9,25].…”

“…It is mainly caused by haematogenous spread [1,2,5,25,28], but may also occur as a complication of operative procedures [1,2,9,25]. Therapy consists of operative debridement and stabilization either as a single or multiple stage procedure.…”