Change of Pyogenic and Tuberculous Spondylitis between 2007 and 2016 Year : A Nationwide Study

Abstract

Objective We attempted to compare the incidence of pyogenic spondylitis (PS) and tuberculous spondylitis (TS) between 2007 and 2016. Furthermore, we investigated the patients who underwent surgery in 2016 compared to that in 2007. Methods We used a nationwide database managed by the Korean National Health Insurance Service (NHIS) in 2007 and 2016. Total 9655 patients with a newly diagnosis of PS or TS were enrolled in PS or TS group. Among them, 1721 patients underwent either fusion or decompression surgery. We analyzed demographic distribution of patients according to gender and age and year of diagnosis. Results Comparing between 2007 and 2016, the incidence of PS has increased in 2016 than in 2007 (4874 vs. 2431, p <0.0001). Conversely, declination of incidence of TS was discovered in 2016 compared to 2007 (594 vs. 1756, p <0.0001). Females showed predominance over males regarding both PS and TS (5228 vs. 4427, p <0.0001). Among them, the number of PS patients who underwent surgery increased significantly in 2016 relative to that in 2007 (979 vs. 592, p <0.0001). Conclusion This nationwide study suggests that PS may increase and TS may decrease in Korea. In addition, demand for surgery regarding PS may increase.

Microbiologic Diagnosis of Pyogenic Spondylitis

“…The microorganisms reach the vertebra through hematogenous spread or during a spinal surgery, procedure, or directly from a site close to the vertebra. Microorganisms known to cause infectious spondylitis are diverse, with regional and periodic variation in distribution [ 3 7 ]. The most common species causing infectious spondylitis in Korea are bacteria and Mycobacterium tuberculosis .…”

“…The most common species causing infectious spondylitis in Korea are bacteria and Mycobacterium tuberculosis . Recently, the incidence of pyogenic spondylitis has increased, whereas the incidence of tuberculous spondylitis has decreased [ 7 ]. Brucella is a common etiologic microorganism of infectious spondylitis in the Mediterranean, Middle East, Latin America and West Asia, but it is rare in Korea [ 8 9 ] with a very low incidence of spondylitis caused by non-tuberculous mycobacteria or fungi [ 10 11 12 ].…”

Association of pyogenic spondylitis with congestive heart failure in Korea: a nationwide longitudinal cohort study

“…Our study also showed that PS was associated with an increased prevalence of diabetes mellitus. The reported incidences of PS are increasing due to increased life expectancy; the popularity of spinal, percutaneous invasive interventions; and advanced diagnostic methods [1,[13][14][15][16]. In cases of hematogenous spreading pathogens in PS, Staphylococcus aureus is the predominant pathogen, accounting for half of non-tuberculous cases [17][18][19].…”

Pyogenic Spondylitis Caused by <i>Staphylococcus schleiferi</i> in a Patient with Crohn's Disease

“…Pyogenic spondylitis is an infrequent infection of the spine that arises via a hematogenous route and is most often reported in immunocompromised patients. A recent nationwide study (1) showed a greater increase in pyogenic spondylitis cases than in tuberculous spondylitis cases.…”