Pyogenic spinal infections warrant a total spine MRI
<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 wi...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2023-01-01
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| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/8/1/2023/jbji-8-1-2023.pdf |
| _version_ | 1797964718323793920 |
|---|---|
| author | C. Balcescu K. Odeh A. Rosinski B. Nudelman A. Schlauch I. Shah V. Ungurean Jr. P. Prasad J. Leasure F. Stepansky A. Piple D. Kondrashov |
| author_facet | C. Balcescu K. Odeh A. Rosinski B. Nudelman A. Schlauch I. Shah V. Ungurean Jr. P. Prasad J. Leasure F. Stepansky A. Piple D. Kondrashov |
| author_sort | C. Balcescu |
| collection | DOAJ |
| description | <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> |
| first_indexed | 2024-04-11T01:48:20Z |
| format | Article |
| id | doaj.art-07443e8ad4874e1ea4e1e5aa7dfb67ff |
| institution | Directory Open Access Journal |
| issn | 2206-3552 |
| language | English |
| last_indexed | 2024-04-11T01:48:20Z |
| publishDate | 2023-01-01 |
| publisher | Copernicus Publications |
| record_format | Article |
| series | Journal of Bone and Joint Infection |
| spelling | doaj.art-07443e8ad4874e1ea4e1e5aa7dfb67ff2023-01-03T07:11:14ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522023-01-0181910.5194/jbji-8-1-2023Pyogenic spinal infections warrant a total spine MRIC. Balcescu0K. Odeh1A. Rosinski2B. Nudelman3A. Schlauch4I. Shah5V. Ungurean Jr.6P. Prasad7J. Leasure8F. Stepansky9A. Piple10D. Kondrashov11San Francisco Orthopaedic Residency Program, St. Mary's Medical Center, San Francisco, CA 94117, USASan Francisco Orthopaedic Residency Program, St. Mary's Medical Center, San Francisco, CA 94117, USASan Francisco Orthopaedic Residency Program, St. Mary's Medical Center, San Francisco, CA 94117, USASan Francisco Orthopaedic Residency Program, St. Mary's Medical Center, San Francisco, CA 94117, USASan Francisco Orthopaedic Residency Program, St. Mary's Medical Center, San Francisco, CA 94117, USASan Francisco Orthopaedic Residency Program, St. Mary's Medical Center, San Francisco, CA 94117, USAThe Taylor Collaboration, San Francisco, CA 94117, USADepartment of Internal Medicine, University of California San Francisco, San Francisco, CA 94143, USAThe Taylor Collaboration, San Francisco, CA 94117, USADepartment of Radiology, St. Mary's Medical Center, San Francisco, CA 94117, USAThe Taylor Collaboration, San Francisco, CA 94117, USASpine Center, St. Mary's Medical Center, San Francisco, CA 94117, USA<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>https://jbji.copernicus.org/articles/8/1/2023/jbji-8-1-2023.pdf |
| spellingShingle | C. Balcescu K. Odeh A. Rosinski B. Nudelman A. Schlauch I. Shah V. Ungurean Jr. P. Prasad J. Leasure F. Stepansky A. Piple D. Kondrashov Pyogenic spinal infections warrant a total spine MRI Journal of Bone and Joint Infection |
| title | Pyogenic spinal infections warrant a total spine MRI |
| title_full | Pyogenic spinal infections warrant a total spine MRI |
| title_fullStr | Pyogenic spinal infections warrant a total spine MRI |
| title_full_unstemmed | Pyogenic spinal infections warrant a total spine MRI |
| title_short | Pyogenic spinal infections warrant a total spine MRI |
| title_sort | pyogenic spinal infections warrant a total spine mri |
| url | https://jbji.copernicus.org/articles/8/1/2023/jbji-8-1-2023.pdf |
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