Gas within the Intervertebral Disc Does Not Rule Out Spinal Infection—A Case Series of 135 Patients with Spontaneous Spondylodiscitis
Gas in the intervertebral disc is mainly associated with degenerative disc diseases and experts generally assume that it is unlikely in spinal infection. However, large-scale studies supporting this notion are lacking, which is why our study’s aim was to analyze the prevalence of and factors associa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/5/1089 |
| _version_ | 1797500422692274176 |
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| author | Friederike Schömig Zhao Li Luis Becker Tu-Lan Vu-Han Matthias Pumberger Torsten Diekhoff |
| author_facet | Friederike Schömig Zhao Li Luis Becker Tu-Lan Vu-Han Matthias Pumberger Torsten Diekhoff |
| author_sort | Friederike Schömig |
| collection | DOAJ |
| description | Gas in the intervertebral disc is mainly associated with degenerative disc diseases and experts generally assume that it is unlikely in spinal infection. However, large-scale studies supporting this notion are lacking, which is why our study’s aim was to analyze the prevalence of and factors associated with the occurrence of gas in patients with spontaneous spondylodiscitis. Patients presenting with spontaneous spondylodiscitis from 2006 to 2020 were included retrospectively. Exclusion criteria were previous interventions in the same spinal segment and missing imaging data. Clinical data were retrieved from electronic medical reports. Computed tomography (CT) scans were evaluated for the presence of intervertebral gas. Causative pathogens were identified from CT-guided biopsy, open biopsy, intraoperative tissue samples, and/or blood cultures. 135 patients with a mean age of 66.0 ± 13.7 years were included. In 93 patients (68.9%), a causative pathogen was found. Intervertebral gas was found in 31 patients (23.0%) in total and in 19 patients (20.4%) with positive microbiology. Patients with gas presented with significantly higher body temperatures (37.2 ± 1.1 vs. 36.8 ± 0.7 °C, <i>p</i> = 0.044) and CRP levels (134.2 ± 127.1 vs. 89.8 ± 97.3 mg/L, <i>p</i> = 0.040) on admission. As a considerable number of patients with spondylodiscitis showed intervertebral gas formation, the detection of intervertebral gas is not suited to ruling out spondylodiscitis but must be interpreted in the context of other imaging and clinical findings, especially in elderly patients. |
| first_indexed | 2024-03-10T03:02:40Z |
| format | Article |
| id | doaj.art-2ccf56e09c784cdca9f0d1adf5d03576 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T03:02:40Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-2ccf56e09c784cdca9f0d1adf5d035762023-11-23T10:39:10ZengMDPI AGDiagnostics2075-44182022-04-01125108910.3390/diagnostics12051089Gas within the Intervertebral Disc Does Not Rule Out Spinal Infection—A Case Series of 135 Patients with Spontaneous SpondylodiscitisFriederike Schömig0Zhao Li1Luis Becker2Tu-Lan Vu-Han3Matthias Pumberger4Torsten Diekhoff5Center for Musculoskeletal Surgery, Charité—University Medicine Berlin, Charitéplatz 1, 10117 Berlin, GermanyCenter for Musculoskeletal Surgery, Charité—University Medicine Berlin, Charitéplatz 1, 10117 Berlin, GermanyCenter for Musculoskeletal Surgery, Charité—University Medicine Berlin, Charitéplatz 1, 10117 Berlin, GermanyCenter for Musculoskeletal Surgery, Charité—University Medicine Berlin, Charitéplatz 1, 10117 Berlin, GermanyCenter for Musculoskeletal Surgery, Charité—University Medicine Berlin, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Radiology, Charité—University Medicine Berlin, Charitéplatz 1, 10117 Berlin, GermanyGas in the intervertebral disc is mainly associated with degenerative disc diseases and experts generally assume that it is unlikely in spinal infection. However, large-scale studies supporting this notion are lacking, which is why our study’s aim was to analyze the prevalence of and factors associated with the occurrence of gas in patients with spontaneous spondylodiscitis. Patients presenting with spontaneous spondylodiscitis from 2006 to 2020 were included retrospectively. Exclusion criteria were previous interventions in the same spinal segment and missing imaging data. Clinical data were retrieved from electronic medical reports. Computed tomography (CT) scans were evaluated for the presence of intervertebral gas. Causative pathogens were identified from CT-guided biopsy, open biopsy, intraoperative tissue samples, and/or blood cultures. 135 patients with a mean age of 66.0 ± 13.7 years were included. In 93 patients (68.9%), a causative pathogen was found. Intervertebral gas was found in 31 patients (23.0%) in total and in 19 patients (20.4%) with positive microbiology. Patients with gas presented with significantly higher body temperatures (37.2 ± 1.1 vs. 36.8 ± 0.7 °C, <i>p</i> = 0.044) and CRP levels (134.2 ± 127.1 vs. 89.8 ± 97.3 mg/L, <i>p</i> = 0.040) on admission. As a considerable number of patients with spondylodiscitis showed intervertebral gas formation, the detection of intervertebral gas is not suited to ruling out spondylodiscitis but must be interpreted in the context of other imaging and clinical findings, especially in elderly patients.https://www.mdpi.com/2075-4418/12/5/1089spine surgeryinfectionspondylodiscitisdiagnosisvacuum phenomenon |
| spellingShingle | Friederike Schömig Zhao Li Luis Becker Tu-Lan Vu-Han Matthias Pumberger Torsten Diekhoff Gas within the Intervertebral Disc Does Not Rule Out Spinal Infection—A Case Series of 135 Patients with Spontaneous Spondylodiscitis Diagnostics spine surgery infection spondylodiscitis diagnosis vacuum phenomenon |
| title | Gas within the Intervertebral Disc Does Not Rule Out Spinal Infection—A Case Series of 135 Patients with Spontaneous Spondylodiscitis |
| title_full | Gas within the Intervertebral Disc Does Not Rule Out Spinal Infection—A Case Series of 135 Patients with Spontaneous Spondylodiscitis |
| title_fullStr | Gas within the Intervertebral Disc Does Not Rule Out Spinal Infection—A Case Series of 135 Patients with Spontaneous Spondylodiscitis |
| title_full_unstemmed | Gas within the Intervertebral Disc Does Not Rule Out Spinal Infection—A Case Series of 135 Patients with Spontaneous Spondylodiscitis |
| title_short | Gas within the Intervertebral Disc Does Not Rule Out Spinal Infection—A Case Series of 135 Patients with Spontaneous Spondylodiscitis |
| title_sort | gas within the intervertebral disc does not rule out spinal infection a case series of 135 patients with spontaneous spondylodiscitis |
| topic | spine surgery infection spondylodiscitis diagnosis vacuum phenomenon |
| url | https://www.mdpi.com/2075-4418/12/5/1089 |
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