| Summary: | <p><strong>Study design</strong>: retrospective case series.
<strong>Objective</strong>: the presenting clinical symptoms of spinal infections
are often nonspecific and a delay in diagnosis can lead to adverse patient
outcomes. The morbidity and mortality of patients with multifocal spinal
infections is significantly higher compared to unifocal infections. The
purpose of the current study was to analyse the risk factors for multifocal
spinal infections.
<strong>Methods</strong>: we conducted a retrospective review of all pyogenic
non-tuberculous spinal infections treated surgically at a single tertiary
care medical center from 2006–2020. The medical records, imaging studies,
and laboratory data of 43 patients during this time period were reviewed and
analysed after receiving Institutional Review Board approval. Univariate and
multivariate analyses were performed to identify factors associated with a
multifocal spinal infection.
<strong>Results</strong>: 15 patients (35 %) had multifocal infections. In
univariate analysis, there was a significant association with chronic kidney
disease (<span class="inline-formula"><i>p</i>=0.040</span>), gender (<span class="inline-formula"><i>p</i>=0.003</span>), a white blood cell count
(<span class="inline-formula"><i>p</i>=0.011</span>), and cervical (<span class="inline-formula"><i>p</i><0.001</span>) or thoracic (<span class="inline-formula"><i>p</i><0</span>.001)
involvement. In multivariate analysis, both cervical and thoracic involvement
remained statistically significant (<span class="inline-formula"><i>p</i>=0.001</span> and <span class="inline-formula"><i>p</i><0.001</span>,
respectively).
<strong>Conclusions</strong>: patients with infections in the thoracic or cervical
region are more likely to have a multifocal infection. Multifocal pyogenic
spinal infections remain a common entity and a total spine MRI should be
performed to aid in prompt diagnosis.</p>
|
|---|