Surgical Management of Thoracolumbar Spondylodiscitis in End-Stage Renal Disease

Jain, Kumar; Ravikumar, T

doi:10.1007/s43465-020-00132-4

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…Although ISD could be a possible cause of dorso-lumbar pain syndrome in HD patients, the lack of specificity of the clinical picture might lead to the underdiagnosis of this condition. The articles in the literature cite a series of ISD cases diagnosed in patients in HD programs, without registering enough patients to increase the statistical relevance of the carried-out studies [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ]. In the present study, we identified 13 patients with ISD (about 0.6% out of the 2157 dialyzed over the last 10 years), less than the data in the literature [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…The etiologic agents were found in 28 cases from the biopsy culture: MRSA (38.2%), MSSA (11.7%), Staphylococcus epidermidis (5.8%), Streptococcus (11.7%), Enterococcus (8.8%), and Mycobacterium tuberculosis (5.8%). The antibiotic treatment and its length were not specified [ 48 ].…”

Section: Part Ii—review Of the Literaturementioning

confidence: 99%

“…In conclusion, in ESRD patients MRSA has been found as a major etiology in several studies performed [19,38,39,[41][42][43][44][45][46][47][48][49]53]. Hemodialysis catheters and the period between diagnosis and admission were associated with resistance to medical treatment.…”

Section: Nr Article Number Of Patients Follow-up Periodmentioning

confidence: 99%

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Antimicrobial Treatment Challenges in the Management of Infective Spondylodiscitis Associated with Hemodialysis: A Comprehensive Review of Literature and Case Series Analysis

Ratiu,

Moisa,

Țiburcă

et al. 2024

Antibiotics

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Infective spondylodiscitis (ISD), the infection of vertebral bodies and surrounding tissues, is a rare complication with major impact on the long-term survival of hemodialysis (HD) patients. Although the most frequent etiology is staphylococcal, identifying these pathogens in blood cultures and biopsy cultures is often difficult. This paper aims to present suitable antibiotic combinations for the treatment of these patients, which is usually challenging in the case of an unidentified pathogen. We presented the therapies applied for 13 HD patients and 19 patients without chronic kidney disease (CKD), diagnosed with ISD between 2013 and 2023 in Bihor County. The percentage of positive blood cultures was low in both groups (30.78% HD vs. 15.78% non-HD). The average length of antibiotic therapy was 5.15 weeks in HD patients and 6.29 weeks in non-HD patients. The use of Carbapenem alone (e.g., Meropenem) for an average of 19.6 days for patients in HD when the pathogen was not identified has proven to be efficient in most cases, similarly to using Vancomycin and Fluoroquinolone/Cephalosporines in combination. Regarding the non-CKD patients, the use of Clindamycin in various combinations for an average of 30.3 days has proven to be efficient in more than 90% of cases of ISD with a nonidentified pathogen. Within 2 years after ISD was diagnosed, 12 of the 13 HD patients passed away, mainly due to cardiovascular causes. Unfortunately, there are no guidelines in the literature concerning the empiric treatment of ISD in the particular case of HD patients. Upon checking the literature on PubMed and Google Scholar, only 10 studies provided relevant data regarding ISD treatment for HD patients. More data about the treatment and evolution of these patients is needed in order to elaborate a truly relevant metanalysis.

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Section: Discussionmentioning

confidence: 99%

Section: Part Ii—review Of the Literaturementioning

confidence: 99%

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Antimicrobial Treatment Challenges in the Management of Infective Spondylodiscitis Associated with Hemodialysis: A Comprehensive Review of Literature and Case Series Analysis

Ratiu,

Moisa,

Țiburcă

et al. 2024

Antibiotics

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“…Management of vertebral osteomyelitis depends upon a number of factors including the presence of sepsis, segmental instability, or epidural abscess causing neurologic compromise, which would indicate the need for surgical treatment rather than medical treatment with pathogen-associated parenteral or oral antibiotic therapy [ 1 - 3 ]. Surgical treatment includes debridement and spinal stabilization.…”

Section: Introductionmentioning

confidence: 99%

A Novel Construct to Treat Destructive Osteomyelitis of the Lumbar Spine in a Patient With Pre-existing Paraplegia

Eliahu¹,

Basil²,

Wang³

2022

Cureus

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Infective spondylodiscitis in hemodialysis patients

Cassó-Troche¹,

Echavarría-Uceta

Quiñones-Robles³

et al. 2022

Surgical Neurology International

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Background: Spondylodiscitis is a potentially catastrophic complication in patients on hemodialysis. It is slow and insidious onset and nonspecific symptoms have contributed to the late detection of this infectious process. Here, we reviewed the clinical characteristics and outcomes for patients on hemodialysis who developed spondylodiscitis who were diagnosed with spondylodiscitis. Methods: From 2011 to 2021, 11 (0.4%) of 2557 patients on hemodialysis were diagnosed with spondylodiscitis based on clinical symptoms, patients averaged 56.9 years of age, seven were male, and they presented with fever in just two cases. The most frequent comorbidities included hypertension (ten patients) and diabetes mellitus (seven patients). Here, we reviewed the clinical, radiological (i.e., MR scans), laboratory markers, and treatment choices (i.e., nonsurgical vs. surgical) for these 11 hemodialysis patients. Results: Ten of the 11 patients underwent spinal surgery, and five were later readmitted for recurrent of infections. There was just one nonsurgical mortality. Conclusion: For patients on hemodialysis, the new-onset of spinal pain may signal the onset of spondylodiscitis which should be rapidly diagnosed with MR studies and managed in a timely fashion either with antibiotic therapy and/or with surgery/antibiotics.

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Surgical Management of Thoracolumbar Spondylodiscitis in End-Stage Renal Disease

Cited by 3 publications

References 12 publications

Antimicrobial Treatment Challenges in the Management of Infective Spondylodiscitis Associated with Hemodialysis: A Comprehensive Review of Literature and Case Series Analysis

Antimicrobial Treatment Challenges in the Management of Infective Spondylodiscitis Associated with Hemodialysis: A Comprehensive Review of Literature and Case Series Analysis

A Novel Construct to Treat Destructive Osteomyelitis of the Lumbar Spine in a Patient With Pre-existing Paraplegia

Infective spondylodiscitis in hemodialysis patients

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