Treatment of Spondylodiscitis in Human Immunodeficiency Virus-Infected Patients

Sobottke, Rolf; Zarghooni, Kourosh; Krengel, Maxine; Delank, S.; Seifert, Harald; Fätkenheuer, Gerd; Ernestus, I; Källicke, T; Frangen, T.M.; Arastéh, Keikawus; Oette, Mark; Eysel, Peer

doi:10.1097/brs.0b013e3181a0aa5b

Cited by 33 publications

(30 citation statements)

References 23 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Concomitant surgical stabilization is [28,36,[44][45][46]. The two studies focusing on immunosuppressed patients described that surgical treatment in HIV patients is not associated with more complications, while early hardware failure was more common in surgically treated IVDUs [33,47].…”

Section: Discussionmentioning

confidence: 99%

“…Two studies focused on the treatment of specific patient groups [33,47]. Sobottke et al retrospectively compared surgical with systemic antibiotics therapy alone in HIV patients and found no statistically increased complication or relapse rate in the surgically treated patients [33].…”

Section: Treatment Of Hiv and Ivdu Patientsmentioning

confidence: 99%

“…This resulted in 25 included studies (Table 3). Ten studies containing only a minority of tuberculosis or postoperative infection cases (2.9-38 %) were included in the review [16][17][18][27][28][29][30][31][32][33]. At total of 75 patients in the current review had tuberculosis and 52 patients had a postoperative infection, which represented, respectively, 3.1 and 2.2 % of all included patients.…”

Section: Study Selectionmentioning

confidence: 99%

“…Sobottke et al retrospectively compared surgical with systemic antibiotics therapy alone in HIV patients and found no statistically increased complication or relapse rate in the surgically treated patients [33]. Wang et al prospectively compared the outcome of spondylodiscitis in intravenous drug users (IVDUs) and nonIVDUs [47].…”

Section: Treatment Of Hiv and Ivdu Patientsmentioning

confidence: 99%

“…Fifteen of the included studies contain a minority of patients that no completely meet our inclusion criteria [4, 16-18, 27-36, 44]. Ten studies include a small number patients with tuberculosis and postoperative infections representing, respectively, 3.1 and 2.2 % of the included patient in this review [16][17][18][27][28][29][30][31][32][33]. Moreover seven studies included children and adolescents representing 1.3 % of the study population of this review [4,27,32,[34][35][36]44].…”

Section: Strength and Limitationsmentioning

confidence: 99%

See 4 more Smart Citations

Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

et al. 2015

View full text Add to dashboard Cite

Background Spondylodiscitis is a spinal infection affecting primarily the intervertebral disk and the adjacent vertebral bodies. Currently many aspects of the treatment of pyogenic spondylodiscitis are still a matter of debate. Purpose The aim of this study was to review the currently available literature systematically to determine the outcome of patients with pyogenic spondylodiscitis for conservative and surgical treatment strategies. Methods A systematic electronic search of MEDLINE, EMBASE, Cochrane Collaboration, and Web of Science regarding the treatment of pyogenic spondylodiscitis was performed. Included articles were assessed on risk of bias according the Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence and strength of recommendation was evaluated according the GRADE approach. Results 25 studies were included. Five studies had a high or moderate quality of evidence. One RCT suggest that 6 weeks of antibiotic treatment of pyogenic spondylodiscitis results in a similar outcome when compared to longer treatment duration. However, microorganism-specific studies suggest that at least 8 weeks of treatment is required for S. aureus and 8 weeks of Daptomycin for MRSA. The articles that described the outcome of surgical treatment strategies show that a large variety of surgical techniques can successfully treat spondylodiscitis. No additional long-term beneficial effect of surgical treatment could be shown in the studies comparing surgical versus antibiotic only treatment. Conclusion There is a strong level of recommendation for 6 weeks of antibiotic treatment in pyogenic spondylodiscitis although this has only been shown by one recent RCT. If surgical treatment is indicated, it has been suggested by two prospective studies with strong level of recommendation that an isolated anterior approach could result in a better clinical outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Treatment Of Hiv and Ivdu Patientsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Treatment Of Hiv and Ivdu Patientsmentioning

confidence: 99%

Section: Strength and Limitationsmentioning

confidence: 99%

See 3 more Smart Citations

Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

et al. 2015

View full text Add to dashboard Cite

show abstract

Preclinical models of vertebral osteomyelitis and associated infections: Current models and recommendations for study design

2021

View full text Add to dashboard Cite

Spine-related infections, such as vertebral osteomyelitis, discitis, or spondylitis, are rare diseases that mostly affect adults, and are usually of hematogenous origin. The incidence of this condition has gradually risen in recent years because of increases in spine-related surgery and hospital-acquired infections, an aging population, and intravenous (IV) drug use. Spine infections are most commonly caused by Staphylococcus aureus, while other systemic infections such as tuberculosis and brucellosis can also cause spondylitis. Various animal models of vertebral osteomyelitis and associated infections have been investigated in mouse, rat, chicken, rabbit, dog, and sheep models by hematogenous and direct inoculation in surgery, each with their strengths and limitations. This review is the first of its kind to concisely analyze the various existing animal models used to reproduce clinically relevant models of infection. Spine-related infection models must address the unique anatomy of the spine, the avascular nature of its structures and tissues and the consequences of tissue destruction such as spinal cord compression. Further investigation is necessary to elucidate the specific mechanisms of host-microbe response to inform antimicrobial therapy and administration techniques in a technically demanding body cavity. Small-animal models are not suitable for large instrumentation, and difficult IV access thwarts antibiotic administration. In contrast, large-animal models can be implanted with clinically relevant instrumentation and are resilient to repeat procedures to study postoperative infection. A canine model of infection offers a unique opportunity to design and investigate antimicrobial treatments through recruitment a rich population of canine patients, presenting with a natural disease that is suitable for randomized trials.

show abstract

Spinal Infections: Evidence-Based Neuroimaging

Roudsari

Jarvik

2013

Evidence-Based Neuroimaging Diagnosis and Treatment

View full text Add to dashboard Cite

Treatment of Spondylodiscitis in Human Immunodeficiency Virus-Infected Patients

Cited by 33 publications

References 23 publications

Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

Preclinical models of vertebral osteomyelitis and associated infections: Current models and recommendations for study design

Spinal Infections: Evidence-Based Neuroimaging

Contact Info

Product

Resources

About