Neurosurgical Management and Outcome Parameters in 237 Patients with Spondylodiscitis
Surgical treatment of spondylodiscitis allows for rapid mobilization and shortens hospital stays, which makes surgical treatment the first-line therapy. We aim to describe our experiences with operative treatment on spondylodiscitis and to determine the parameters that are important in the predictio...
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| Format: | Article |
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MDPI AG
2021-07-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/11/8/1019 |
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| author | Mirza Pojskić Barbara Carl Vincent Schmöckel Benjamin Völlger Christopher Nimsky Benjamin Saβ |
| author_facet | Mirza Pojskić Barbara Carl Vincent Schmöckel Benjamin Völlger Christopher Nimsky Benjamin Saβ |
| author_sort | Mirza Pojskić |
| collection | DOAJ |
| description | Surgical treatment of spondylodiscitis allows for rapid mobilization and shortens hospital stays, which makes surgical treatment the first-line therapy. We aim to describe our experiences with operative treatment on spondylodiscitis and to determine the parameters that are important in the prediction of outcomes. A retrospective review identified 237 patients who were operatively treated for spondylodiscitis in our institution between January 2010 and December 2018. Clinical data were collected through review of electronic records and relevant imaging. In all cases, contrast-enhancing MRI from the infected region of the spine was obtained. Leukocyte count and C-reactive protein concentrations (CRP) were determined in all the patients. We included 237 patients in the study, 87 female (36.7%) and 150 male (63.3%), with a mean age of 71.4 years. Mean follow-up was 31.6 months. Forty-five patients had spondylodiscitis of the cervical, 73 of the thoracic, and 119 of the lumbosacral spine. All the patients with spondylodiscitis of the cervical spine received instrumentation. In thoracic and lumbar spine decompression, surgery without instrumentation was performed in 26 patients as immediate surgery and in a further 28 patients in the early stages following admission, while 138 patients received instrumentation. Eighty-nine patients (37.6%) had concomitant infections. Infection healing occurred in 89% of patients. Favorable outcomes were noted in patients without concomitant infections, with a normalized CRP value and in patients who received antibiotic therapy for more than six weeks (<i>p</i> < 0.05). Unfavorable outcomes were noted in patients with high CRP, postoperative spondylodiscitis, and recurrent spondylodiscitis (<i>p</i> < 0.05). Application of antibiotic therapy for more than six weeks and normalized CRP showed a correlation with favorable outcomes, whereas concomitant infections showed a correlation with unfavorable outcomes. A detailed screening for concomitant infectious diseases is recommended. |
| first_indexed | 2024-03-10T08:58:36Z |
| format | Article |
| id | doaj.art-9170d7f0ad8a4de49ece7e3cedb9019c |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T08:58:36Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-9170d7f0ad8a4de49ece7e3cedb9019c2023-11-22T06:58:50ZengMDPI AGBrain Sciences2076-34252021-07-01118101910.3390/brainsci11081019Neurosurgical Management and Outcome Parameters in 237 Patients with SpondylodiscitisMirza Pojskić0Barbara Carl1Vincent Schmöckel2Benjamin Völlger3Christopher Nimsky4Benjamin Saβ5Department of Neurosurgery, University of Marburg, 65199 Marburg, GermanyDepartment of Neurosurgery, University of Marburg, 65199 Marburg, GermanyDepartment of Neurosurgery, University of Marburg, 65199 Marburg, GermanyDepartment of Neurosurgery, University of Marburg, 65199 Marburg, GermanyDepartment of Neurosurgery, University of Marburg, 65199 Marburg, GermanyDepartment of Neurosurgery, University of Marburg, 65199 Marburg, GermanySurgical treatment of spondylodiscitis allows for rapid mobilization and shortens hospital stays, which makes surgical treatment the first-line therapy. We aim to describe our experiences with operative treatment on spondylodiscitis and to determine the parameters that are important in the prediction of outcomes. A retrospective review identified 237 patients who were operatively treated for spondylodiscitis in our institution between January 2010 and December 2018. Clinical data were collected through review of electronic records and relevant imaging. In all cases, contrast-enhancing MRI from the infected region of the spine was obtained. Leukocyte count and C-reactive protein concentrations (CRP) were determined in all the patients. We included 237 patients in the study, 87 female (36.7%) and 150 male (63.3%), with a mean age of 71.4 years. Mean follow-up was 31.6 months. Forty-five patients had spondylodiscitis of the cervical, 73 of the thoracic, and 119 of the lumbosacral spine. All the patients with spondylodiscitis of the cervical spine received instrumentation. In thoracic and lumbar spine decompression, surgery without instrumentation was performed in 26 patients as immediate surgery and in a further 28 patients in the early stages following admission, while 138 patients received instrumentation. Eighty-nine patients (37.6%) had concomitant infections. Infection healing occurred in 89% of patients. Favorable outcomes were noted in patients without concomitant infections, with a normalized CRP value and in patients who received antibiotic therapy for more than six weeks (<i>p</i> < 0.05). Unfavorable outcomes were noted in patients with high CRP, postoperative spondylodiscitis, and recurrent spondylodiscitis (<i>p</i> < 0.05). Application of antibiotic therapy for more than six weeks and normalized CRP showed a correlation with favorable outcomes, whereas concomitant infections showed a correlation with unfavorable outcomes. A detailed screening for concomitant infectious diseases is recommended.https://www.mdpi.com/2076-3425/11/8/1019spondylodiscitisspinal empyemaantibiotic therapyosteomyelitisinfectionspine |
| spellingShingle | Mirza Pojskić Barbara Carl Vincent Schmöckel Benjamin Völlger Christopher Nimsky Benjamin Saβ Neurosurgical Management and Outcome Parameters in 237 Patients with Spondylodiscitis Brain Sciences spondylodiscitis spinal empyema antibiotic therapy osteomyelitis infection spine |
| title | Neurosurgical Management and Outcome Parameters in 237 Patients with Spondylodiscitis |
| title_full | Neurosurgical Management and Outcome Parameters in 237 Patients with Spondylodiscitis |
| title_fullStr | Neurosurgical Management and Outcome Parameters in 237 Patients with Spondylodiscitis |
| title_full_unstemmed | Neurosurgical Management and Outcome Parameters in 237 Patients with Spondylodiscitis |
| title_short | Neurosurgical Management and Outcome Parameters in 237 Patients with Spondylodiscitis |
| title_sort | neurosurgical management and outcome parameters in 237 patients with spondylodiscitis |
| topic | spondylodiscitis spinal empyema antibiotic therapy osteomyelitis infection spine |
| url | https://www.mdpi.com/2076-3425/11/8/1019 |
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