Polysegmental and multilevel lesions in hematogenous vertebral osteomyelitis: assessment of immediate and long-term results

Objective. To analyze the results of treatment of disseminated (polysegmental and multilevel) forms of hematogenous vertebral osteomyelitis (HVO) as compared with those of monosegmental and monovertebral lesions. Material and Methods. A retrospective analysis of a monocenter cohort of 266 patients...

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Main Authors: Aleksandr Yu. Bazarov, Konstantin S. Sergeyev, Nadezhda P. Sidoryak
Format: Article
Language:English
Published: Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" 2023-03-01
Series:Хирургия позвоночника
Subjects:
Online Access:https://www.spinesurgery.ru/jour/article/view/1992/1982
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author Aleksandr Yu. Bazarov
Konstantin S. Sergeyev
Nadezhda P. Sidoryak
author_facet Aleksandr Yu. Bazarov
Konstantin S. Sergeyev
Nadezhda P. Sidoryak
author_sort Aleksandr Yu. Bazarov
collection DOAJ
description Objective. To analyze the results of treatment of disseminated (polysegmental and multilevel) forms of hematogenous vertebral osteomyelitis (HVO) as compared with those of monosegmental and monovertebral lesions. Material and Methods. A retrospective analysis of a monocenter cohort of 266 patients with hematogenous osteomyelitis of the spine for 2006 to 2019 was carried out. Patients were divided into two groups: Group A (polysegmental and multilevel lesions) included 33 (12.4 %) patients and Group B (monosegmental and monovertebral lesions) – 233 (87.6 %) patients. The main examination methods were: clini- cal, radiological (standardized roentgenography, CT), MRI, microbiological, histological and statistical ones. Results. Comparison revealed that involvement of the cervical (p < 0.001) and thoracic (p = 0.014) spine was more typical for polyseg- mental and multilevel lesions. There was a tendency to the predominance of type A lesions according to the Pola classification in patients with local forms (p = 0.078) and to the increase in type C lesions in polysegmental and multilevel processes (p = 0.035). The number of neurological complications was higher in polysegmental and multilevel lesions (p = 0.003). There were no significant differences in the treatment results, the number of relapses and mortality rate between the compared groups. Conclusion. Lesions of the cervical and thoracic spine and the presence of a neurological deterioration are typical for multilevel and polysegmental HVO. The formation of a multilevel lesion in different regions of the spine with a gap of 2–4 weeks or more requires a separate implementation of the diagnostic algorithm, defining of classification criteria and differentiated treatment tactics for each focus.
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spelling doaj.art-378edd55cf4f48b3bc3c315b56a782ef2023-09-03T13:34:53ZengMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"Хирургия позвоночника1810-89972313-14972023-03-01201758410.14531/ss2023.1.75-84Polysegmental and multilevel lesions in hematogenous vertebral osteomyelitis: assessment of immediate and long-term resultsAleksandr Yu. Bazarov0https://orcid.org/0000-0002-5309-4667Konstantin S. Sergeyev1https://orcid.org/0000-0002-6621-9449Nadezhda P. Sidoryak2https://orcid.org/0000-0002-4375-7615Tyumen Regional Clinical Hospital No. 2, Tyumen, Russia; Tyumen State Medical University, Tyumen, RussiaTyumen State Medical University, Tyumen, RussiaTyumen Regional Clinical Hospital No. 2, Tyumen, RussiaObjective. To analyze the results of treatment of disseminated (polysegmental and multilevel) forms of hematogenous vertebral osteomyelitis (HVO) as compared with those of monosegmental and monovertebral lesions. Material and Methods. A retrospective analysis of a monocenter cohort of 266 patients with hematogenous osteomyelitis of the spine for 2006 to 2019 was carried out. Patients were divided into two groups: Group A (polysegmental and multilevel lesions) included 33 (12.4 %) patients and Group B (monosegmental and monovertebral lesions) – 233 (87.6 %) patients. The main examination methods were: clini- cal, radiological (standardized roentgenography, CT), MRI, microbiological, histological and statistical ones. Results. Comparison revealed that involvement of the cervical (p < 0.001) and thoracic (p = 0.014) spine was more typical for polyseg- mental and multilevel lesions. There was a tendency to the predominance of type A lesions according to the Pola classification in patients with local forms (p = 0.078) and to the increase in type C lesions in polysegmental and multilevel processes (p = 0.035). The number of neurological complications was higher in polysegmental and multilevel lesions (p = 0.003). There were no significant differences in the treatment results, the number of relapses and mortality rate between the compared groups. Conclusion. Lesions of the cervical and thoracic spine and the presence of a neurological deterioration are typical for multilevel and polysegmental HVO. The formation of a multilevel lesion in different regions of the spine with a gap of 2–4 weeks or more requires a separate implementation of the diagnostic algorithm, defining of classification criteria and differentiated treatment tactics for each focus.https://www.spinesurgery.ru/jour/article/view/1992/1982vertebral osteomyelitisspondylitisspondylodiscitismultilevel lesionpolysegmental lesion
spellingShingle Aleksandr Yu. Bazarov
Konstantin S. Sergeyev
Nadezhda P. Sidoryak
Polysegmental and multilevel lesions in hematogenous vertebral osteomyelitis: assessment of immediate and long-term results
Хирургия позвоночника
vertebral osteomyelitis
spondylitis
spondylodiscitis
multilevel lesion
polysegmental lesion
title Polysegmental and multilevel lesions in hematogenous vertebral osteomyelitis: assessment of immediate and long-term results
title_full Polysegmental and multilevel lesions in hematogenous vertebral osteomyelitis: assessment of immediate and long-term results
title_fullStr Polysegmental and multilevel lesions in hematogenous vertebral osteomyelitis: assessment of immediate and long-term results
title_full_unstemmed Polysegmental and multilevel lesions in hematogenous vertebral osteomyelitis: assessment of immediate and long-term results
title_short Polysegmental and multilevel lesions in hematogenous vertebral osteomyelitis: assessment of immediate and long-term results
title_sort polysegmental and multilevel lesions in hematogenous vertebral osteomyelitis assessment of immediate and long term results
topic vertebral osteomyelitis
spondylitis
spondylodiscitis
multilevel lesion
polysegmental lesion
url https://www.spinesurgery.ru/jour/article/view/1992/1982
work_keys_str_mv AT aleksandryubazarov polysegmentalandmultilevellesionsinhematogenousvertebralosteomyelitisassessmentofimmediateandlongtermresults
AT konstantinssergeyev polysegmentalandmultilevellesionsinhematogenousvertebralosteomyelitisassessmentofimmediateandlongtermresults
AT nadezhdapsidoryak polysegmentalandmultilevellesionsinhematogenousvertebralosteomyelitisassessmentofimmediateandlongtermresults