Risk factors and prognosis of vertebral compressive fracture in pyogenic vertebral osteomyelitis

Ribera, Alba; Labori, Maria; Hernández, J; Lora‐Tamayo, Jaime; González-Cañas, Lluís; Font, F.J. Agüera; Nolla, Joan M.; Ariza, Javier; Narváez, José Antonio; Murillo, Óscar

doi:10.1007/s15010-015-0800-z

Cited by 5 publications

(5 citation statements)

References 30 publications

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“…They also reported that such cases of atypical vertebral osteomyelitis had an incidence of 11% among 253 patients with vertebral osteomyelitis 5) . In more recent studies, Ribera et al reported that vertebral fractures in PVO were observed in a higher frequency of 35% than what was previously reported 29) . They also reported that patients with vertebral fracture showed slower clinical improvement than those without in PVO.…”

Section: Discussionmentioning

confidence: 76%

Life Expectancy Is Poor in Patients with Diffuse Idiopathic Skeletal Hyperostosis-Related Pyogenic Vertebral Osteomyelitis

Yamada

Ieguchi

Takahashi

et al. 2022

Spine Surg Relat Res

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Introduction: Pyogenic vertebral osteomyelitis (PVO) is an uncommon but life-threatening infectious disease. Diffuse idiopathic skeletal hyperostosis (DISH) is an age-related disorder and sometimes problematic in terms of spinal instability or high mortality, especially in cases of DISH-related fracture. Meanwhile, no reports have focused on the impact of DISH on the clinical outcomes after treatment for PVO. We hypothesized that PVO occurring at DISH-related segments might contribute to poor clinical results or high mortality rates. The purpose of this study was to investigate the impact of DISH on mortality after treatment for PVO in a retrospective cohort study.Methods: This study involved patients who were hospitalized and treated for PVO at a single institution. DISH-related PVO was defined as PVO within a segment ossified by DISH or PVO at the neighboring intervertebral level of the segment ossified by DISH. Differences in mortality between patients with DISH-related and non-DISH-related PVO were investigated.Results: This study included 55 patients. DISH-related PVO was observed in 13 patients. The mortality rate was significantly higher in patients with DISH-related PVO than in those with non-DISH-related PVO (62% and 23%, respectively; p= 0.016). Propensity score-adjusted analysis showed that DISH-related PVO was an independent risk factor for mortality (adjusted hazard ratio, 2.79; p=0.034). The survival probability was significantly shorter in patients with DISH-related PVO than in those with non-DISH-related PVO (p=0.006). PVO in which the intravertebral body was the center of involvement was significantly more common in DISH-related PVO than in non-DISH-related PVO (38% and 5%, respectively; p=0.006).Conclusions: DISH-related PVO was associated with a higher mortality rate and shorter life expectancy than non-DISHrelated PVO. Similar to advanced age, PVO at the segment ossified by DISH should be recognized as a risk factor for mortality when choosing the optimal treatment strategy.

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Section: Discussionmentioning

confidence: 76%

Life Expectancy Is Poor in Patients with Diffuse Idiopathic Skeletal Hyperostosis-Related Pyogenic Vertebral Osteomyelitis

Yamada

Ieguchi

Takahashi

et al. 2022

Spine Surg Relat Res

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“…Debridement and reconstruction are two main principles of the surgical treatment of pyogenic spondylitis [ 24 , 25 ]. The anterior approach provides direct visualization for radical debridement and decompression without affecting the posterior elements, which is the best way to control the infection and promote definitive healing, and it also can warrant adequate and strong reconstruction with modern instrumentation tools [ 10 – 12 ].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic-loaded calcium sulfate beads in spinal surgery for patients with spondylodiscitis: a clinical retrospective study

Tang

Wang

et al. 2022

BMC Musculoskelet Disord

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Background Various surgical techniques for treating spondylodiscitis have been proposed, but the optimal surgical treatment remains controversial. In this study, we propose a new procedure that is implanting antibiotic-loaded calcium sulfate (CS) beads into the disc after debridement using the Quadrant channel combined with percutaneous fixation through a single-stage posterolateral approach for the treatment of spondylodiscitis. Thus, the purpose of this study is to assess the safety and efficacy of this procedure. Methods This study collected the data of 32 patients with spine spondylodiscitis and was surgically treated in our department from July 2015 to August 2020. The Demographic data included age, gender, involved segment, and complications were collected. The intra-operative details, results of culture, functional outcome, radiologic outcome, and length of hospital stay, laboratory examination were recorded. Results The mean age of the 32 patients was 61.1 ± 9.7 years old. The mean operative time was 135.0 ± 30.6 minutes, and the mean blood loss was 243.4 ± 92.1 ml. The positive rate of culture was 72%. The mean Visual analogue scale (VAS) and Oswestry Disability Index (ODI) score significantly improved from 7.5 to 1.6 and from 65% to 10%. Cobb angle was significantly improved and could be maintained at final follow-up. New bone formation was observed in all patients. There were no recurrences of infection in our study. Conclusions The posterolateral debridement and percutaneous fixation combined with antibiotic-loaded calcium sulfate beads filling are effective in the treatment of spondylodiscitis in terms of infection control, early mobilization, and recovery.

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“…Debridement and reconstruction are two main principles of the surgical treatment of pyogenic spondylitis [23,24]. The anterior approach provides direct visualization for radical debridement and decompression without affecting the posterior elements,which is the best way to control the infection and promote de nitive healing, and it also can warrant adequate and strong reconstruction with modern instrumentation tools [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Combination Use of Antibiotic-Loaded Calcium Sulfate Beads in Spinal Surgery for Patients with Spondylodiscitis：A Clinical Retrospective Study

Tang¹,

Li²,

Wang³

et al. 2021

Preprint

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Background. Various surgical techniques for treating spondylodiscitis have been proposed, but the optimal surgical treatment remains controversial. In this study, we propose a new procedure that is implanting antibiotic-loaded calcium sulfate (CS) beads into the disc after infection site debrided by Quadrant channel combined with percutaneous fixation through a single-stage posterior approach for the treatment of spondylodiscitis. Thus, the purpose of this study is to assess the safety and efficacy of this procedure. Methods. This study collected 32 patients’ clinical data of whom had spine spondylodiscitis treated in our department from July of 2015 to August of 2020. The Demographic data included age, gender, involved segment and complications were collected. The intra-operative details, results of culture, functional outcome, radiologic outcome, and length of hospital stay, laboratory examination were recorded. Results. The mean age of the 32 patients was 61.1 ± 9.7 years old. The mean operative time was 135.0 ± 30.6 minutes, and the mean blood loss was 243.4 ± 92.1 ml. The positive rate of culture was 72%. The mean Visual analogue scale (VAS) and Oswestry Disability Index (ODI) score significantly improved from 7.5 to 1.6 and from 65–10%. Cobb angle was significantly improved and could be maintained at final follow-up. Solid bone fusion was achieved in all patients. There were no recurrences of infection in our study. Conclusions. The procedure we proposed is effective in the treatment of spondylodiscitis, the infection site can be debrided and controlled exactly, and spinal stabilization can also be achieved.

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Risk factors and prognosis of vertebral compressive fracture in pyogenic vertebral osteomyelitis

Cited by 5 publications

References 30 publications

Life Expectancy Is Poor in Patients with Diffuse Idiopathic Skeletal Hyperostosis-Related Pyogenic Vertebral Osteomyelitis

Life Expectancy Is Poor in Patients with Diffuse Idiopathic Skeletal Hyperostosis-Related Pyogenic Vertebral Osteomyelitis

Antibiotic-loaded calcium sulfate beads in spinal surgery for patients with spondylodiscitis: a clinical retrospective study

Combination Use of Antibiotic-Loaded Calcium Sulfate Beads in Spinal Surgery for Patients with Spondylodiscitis：A Clinical Retrospective Study

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