Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review
Objective. To analyze the results of surgical treatment of chronic infectious cervical spondylitis and literature data. Material and Methods. Design: retrospective monocentric cohort study for 2017–2020. The study included medical history and clini- cal and instrumental data of 25 patients who und...
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| Format: | Article |
| Language: | English |
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Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
2021-09-01
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| Series: | Хирургия позвоночника |
| Subjects: | |
| Online Access: | https://www.spinesurgery.ru/jour/article/view/1830/1826 |
| _version_ | 1797719225457967104 |
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| author | Denis G. Naumov Sergey G. Tkach Aleksandr Yu. Mushkin Marina E. Makogonova |
| author_facet | Denis G. Naumov Sergey G. Tkach Aleksandr Yu. Mushkin Marina E. Makogonova |
| author_sort | Denis G. Naumov |
| collection | DOAJ |
| description | Objective. To analyze the results of surgical treatment of chronic infectious cervical spondylitis and literature data.
Material and Methods. Design: retrospective monocentric cohort study for 2017–2020. The study included medical history and clini-
cal and instrumental data of 25 patients who underwent 28 reconstructive surgeries on the suboccipital (n1 = 3) and subaxial (n2 = 25)
spine. The average follow-up period was 1 year 2 months ± 4 months. Statistical analysis was performed using the Statistical Package for
the Social Sciences (SPSS), version 22.0.
Results. The effect of the duration of the therapeutic pause (p = 0.043) and the T1 slope (T1S) (p = 0.022) on the intensity of verte-
brogenic pain syndrome was established. When assessing the parameters of the sagittal balance a direct relationship between the age of
patients and the value of cervical sagittal vertical axis (CSVA) (p = 0.035) was revealed, while CSVA (p = 0.514) and neck tilt angle
(NTA) (p = 0.617) did not significantly affect the intensity of vertebral pain syndrome. The extent of vertebral destruction did not affect
either the intensity of vertebral pain (p = 0.872) or the indices of the sagittal balance: CSVA (p = 0.116), T1S (p = 0.154), and NTA
(p = 0.562). A significant predictor of postoperative complications is the level of comorbidity with an index of 7 or more (p = 0.027) ac-
cording to the Charlson scale.
Conclusion. The leading predictors of complications of surgical treatment of cervical infectious spondylitis are the Charlson comorbidity
index (7 points or more) and the variant of anterior reconstruction (the use of a blocked extraspinal plate). The factors influencing the
intensity of vertebrogenic pain syndrome in this pathology are the duration of the therapeutic pause and the magnitude of T1S compen-
sation. Anterior reconstruction of the cervical spine in the presence of infectious spondylitis provides a correction of the sagittal balance
parameters, with the possibility of long-term maintaining the achieved values. |
| first_indexed | 2024-03-12T09:02:36Z |
| format | Article |
| id | doaj.art-5f2dae9a62754686adda6521ebee6d3b |
| institution | Directory Open Access Journal |
| issn | 1810-8997 2313-1497 |
| language | English |
| last_indexed | 2024-03-12T09:02:36Z |
| publishDate | 2021-09-01 |
| publisher | Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" |
| record_format | Article |
| series | Хирургия позвоночника |
| spelling | doaj.art-5f2dae9a62754686adda6521ebee6d3b2023-09-02T15:34:35ZengMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"Хирургия позвоночника1810-89972313-14972021-09-01183687610.14531/ss2021.3.68-76Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature reviewDenis G. Naumov0https://orcid.org/0000-0002-9892-6260Sergey G. Tkach1https://orcid.org/0000-0001-7135-7312Aleksandr Yu. Mushkin2https://orcid.org/0000-0002-1342-3278Marina E. Makogonova3https://orcid.org/0000-0001-6760-2426St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Russia; St. Petersburg State University, Saint Petersburg, RussiaSt. Petersburg State University, St. Petersburg, RussiaSt. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Russia; Pavlov First Saint Petersburg State Medical University, St. Petersburg, RussiaSt. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, RussiaObjective. To analyze the results of surgical treatment of chronic infectious cervical spondylitis and literature data. Material and Methods. Design: retrospective monocentric cohort study for 2017–2020. The study included medical history and clini- cal and instrumental data of 25 patients who underwent 28 reconstructive surgeries on the suboccipital (n1 = 3) and subaxial (n2 = 25) spine. The average follow-up period was 1 year 2 months ± 4 months. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 22.0. Results. The effect of the duration of the therapeutic pause (p = 0.043) and the T1 slope (T1S) (p = 0.022) on the intensity of verte- brogenic pain syndrome was established. When assessing the parameters of the sagittal balance a direct relationship between the age of patients and the value of cervical sagittal vertical axis (CSVA) (p = 0.035) was revealed, while CSVA (p = 0.514) and neck tilt angle (NTA) (p = 0.617) did not significantly affect the intensity of vertebral pain syndrome. The extent of vertebral destruction did not affect either the intensity of vertebral pain (p = 0.872) or the indices of the sagittal balance: CSVA (p = 0.116), T1S (p = 0.154), and NTA (p = 0.562). A significant predictor of postoperative complications is the level of comorbidity with an index of 7 or more (p = 0.027) ac- cording to the Charlson scale. Conclusion. The leading predictors of complications of surgical treatment of cervical infectious spondylitis are the Charlson comorbidity index (7 points or more) and the variant of anterior reconstruction (the use of a blocked extraspinal plate). The factors influencing the intensity of vertebrogenic pain syndrome in this pathology are the duration of the therapeutic pause and the magnitude of T1S compen- sation. Anterior reconstruction of the cervical spine in the presence of infectious spondylitis provides a correction of the sagittal balance parameters, with the possibility of long-term maintaining the achieved values.https://www.spinesurgery.ru/jour/article/view/1830/1826spondylitiscervical spinecervical spine reconstructionatlantooccipital fusionsagittal balance |
| spellingShingle | Denis G. Naumov Sergey G. Tkach Aleksandr Yu. Mushkin Marina E. Makogonova Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review Хирургия позвоночника spondylitis cervical spine cervical spine reconstruction atlantooccipital fusion sagittal balance |
| title | Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review |
| title_full | Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review |
| title_fullStr | Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review |
| title_full_unstemmed | Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review |
| title_short | Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review |
| title_sort | chronic infectious lesions of the cervical spine in adults monocentric cohort analysis and literature review |
| topic | spondylitis cervical spine cervical spine reconstruction atlantooccipital fusion sagittal balance |
| url | https://www.spinesurgery.ru/jour/article/view/1830/1826 |
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