Infectious disease of the spine: outcome of rehabilitation

Abstract

Infectious disease of the spine is infrequently seen in the rehabilitation setting. We examined retrospectively 26 patients with spinal infections admitted to the rehabilitation centre over a 6-year period to determine the demographic characteristics, clinical features and outcome after rehabilitation.Their ages ranged from 24 to 83 years (mean=56.4); 65.4% were males. The infection was due to pyogenic bacteria in 14 patients (53.8%) and Mycobacterium tuberculosis in 12 (46.2%). Staphylococcus aureus was the causative agent in 69% of those with pyogenic infections. A history of diabetes mellitus was present in 35.7% of the pyogenic group but in only 8.3% of the tuberculous group. Localised back pain, fever and neurological de®cits were the typical clinical manifestations. The most common site of infection was the thoracic region. Surgery was performed on 24 patients and all received prolonged courses of antibiotics.All but three patients completed the rehabilitation programme. The motor score for the lower limbs and the modi®ed Barthel scores for activities of daily living (ADL) and mobility improved signi®cantly (P50.05) for both pyogenic and tuberculous groups. The amounts of improvement achieved were not signi®cantly di erent between the pyogenic and tuberculous groups except for ADL. Age, gender and the presence of diabetes mellitus did not appear to signi®cantly a ect the neurological or functional outcome in our study population. The majority of patients (87.5%) were discharged to their own homes.

A case of brucellar spondylodiscitis involving the cervical spine

“…In general, published reports on the outcome of rehabilitation have been very limited [6,10]. Isometric exercises must start in acute phase and early mobilization must start in the subacute phase because prolonged immobility results in a wide range of deleterious effects such as reduced work capacity and loss of muscle strength [6].…”

Management of spinal brucellosis and outcome of rehabilitation

“…19 In general, published reports on the outcome of rehabilitation have been very limited. 20 Isometric exercises must start in the acute phase and early mobilisation must start in the subacute phase because prolonged immobility results in a wide range of deleterious e ects such as reduced work capacity and loss of muscle strength. Maximising lower extremity muscular¯exibility is important for allowing normal lumbar motion.…”

“…They also found signi®cant improvements in discharge scores of the same patients in terms of the motor scores for the lower limbs (P50.05). 20 In our study, we determined signi®cant improvements in discharge scores of the patients with respect to their admission to hospital when we evaluated motor scores for lower limbs and MBI (P50.05).…”

Health of people with spinal cord injury in Singapore: implications for rehabilitation planning and implementation

“…A study performed in 1987 provides the only estimate of the incidence of SCI, 27 per million per year [3]. In contrast to that reported in the North American and European literature, the evidence for the outcomes of SCI rehabilitation in Singapore is limited to three studies [3][4][5] that focus on impairments and activity limitations in the immediate post-rehabilitation phase. Health, regardless of the theory used to define it, is more than the presence or absence of disease or certain abilities [6][7][8][9].…”