Multidisciplinary management of spontaneous spinal infections: is there a correlation between timing, type of treatment and outcome?

Landi, Alessandro; Bartolomeo, Alessandro Di; Marotta, Nicola; Iaiani, Giancarlo; Domenicucci, Maurizio; Chiara, Massimo; Salvati, Maurizio; Delfini, Roberto

doi:10.23736/s0390-5616.16.03779-6

Cited by 2 publications

(6 citation statements)

References 49 publications

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“…[30] However, up to 15% of patients can be pain free. [31] Fever is less common, being present in 48%–63% of cases,[3233] with a reduction to 17% in tuberculosis. [34] Neurological impairment, due to spinal cord or root compression, might be encountered in about one-third of the patients.…”

Section: Discussionmentioning

confidence: 99%

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Treatment algorithm for spontaneous spinal infections: A review of the literature

Gregori

Grasso

Iaiani

et al. 2019

J Craniovert Jun Spine

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Background: Primary spinal infections are rare pathologies with an estimated incidence of 5% of all osteomyelitis. The diagnosis can be challenging and this might result in a late identification. The etiological diagnosis is the primary concern to determine the most appropriate treatment. The aim of this review article was to identify the importance of a methodological attitude toward accurate and prompt diagnosis using an algorithm to aid on spinal infection management. Methods: A search was done on spinal infection in some databases including PubMed, ISI Web of Knowledge, Google Scholar, Ebsco, Embasco, and Scopus. Results: Literature reveals that on the basis of a clinical suspicion, the diagnosis can be formulated with a rational use of physical, radiological, and microbiological examinations. Microbiological culture samples can be obtained by a percutaneous computed tomography-guided procedure or by an open surgical biopsy. When possible, the samples should be harvested before antibiotic treatment is started. Indications for surgical treatment include neurological deficits or sepsis, spine instability and/or deformity, presence of epidural abscess and failure of conservative treatment. Conclusion: A multidisciplinary approach involving both a spinal surgeon and an infectious disease specialist is necessary to better define the treatment strategy. Based on literature findings, a treatment algorithm for the diagnosis and management of primary spinal infections is proposed.

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Section: Discussionmentioning

confidence: 99%

“…[34] Neurological impairment, due to spinal cord or root compression, might be encountered in about one-third of the patients. [33] Motor weakness to the upper and lower limbs, sphincter function, and sensory loss to the trunk and limbs must be carefully evaluated.…”

Section: Discussionmentioning

confidence: 99%

Treatment algorithm for spontaneous spinal infections: A review of the literature

Gregori

Grasso

Iaiani

et al. 2019

J Craniovert Jun Spine

Self Cite

View full text Add to dashboard Cite

show abstract

“…[ 25 ] Surgery is mandatory when there is spinal instability or progressive neurological impairment, even if the patient is in treatment with antibiotics. [ 1 3 25 30 31 ] In general, all patients underwent antibiotic therapy for a period of at least 8 weeks and underwent a 6-month and 1-year follow-up with ESR, CRP, and MRI with gadolinium. The antibiotic therapy was based on the antibiogram germ isolated, or when it was not possible to isolate the germ, it has been set on empiric therapy.…”

Section: T Reatment and M Anagementmentioning

confidence: 99%

“…In general, a further period of oral antibiotic therapy is recommended for a period variable from 6 weeks to 3 months. Basing on our experience, recently published in the Journal of Neurosurgical Sciences,[ 31 ] antibiotic therapy is fundamental both for conservative than surgical treatment.…”

Section: T Reatment and M Anagementmentioning

confidence: 99%