Primary Spinal Infections in Patients With Hematologic Immunocompromising Conditions: A Systematic Literature Review

Primary Spinal Infections in Patients With Hematologic Immunocompromising Conditions: A Systematic Literature Review

Primary spinal infections (PSIs) are a group of infectious diseases characterized by inflammation of the end plate-disk unit or its surroundings. PSI is considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSIs, immunocompromising cancers, and...

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Bibliographic Details
Published in:Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews Vol. 7; no. 5
Main Authors: Devico Marciano, Naomie, Beyer, Ryan S., Nguyen, Andrew, Paladugu, Anushka, Hatter, Matthew H., Franklin, Austin, Brown, Nolan J., Willhuber, Gaston Camino, Bhatia, Nitin, Oh, Michael Y., Lee, Yu-Po
Format: Journal Article
Language:English
Published: United States Wolters Kluwer 08-05-2023
Subjects:
Adolescent
Adult
Aged
Aggression
Anti-Bacterial Agents
Bone Plates
Child
Child, Preschool
Female
Hemoglobinopathies
Humans
Infant
Male
Middle Aged
Retrospective Studies
Young Adult
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Summary:Primary spinal infections (PSIs) are a group of infectious diseases characterized by inflammation of the end plate-disk unit or its surroundings. PSI is considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSIs, immunocompromising cancers, and hemoglobinopathies has not been systematically analyzed. We conducted a systematic review to study characteristics, clinical presentation, and mortality of patients with PSI in the setting of hematologic disease. A systematic literature search in PubMed, Web of Science, and Scopus was conducted in April 2022 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included retrospective case series and individual case reports. On careful review, 28 articles published between 1970 and 2022 were selected. These studies featured 29 patients who met inclusion criteria (mean age 29 years, age range 1.5 to 67 years; 63.3% male). Lumbar infection was the most common location (65.5%), with Salmonella (24.1%) as the main causative microorganism. Neurologic compromise was present in 41% of patients, and surgical intervention occurred in 48.3%. Average antibiotic duration was 13 weeks. The postoperative complication rate was 21.4%, with a mortality of 6.9%. PSI in patients with hematologic disease, while having shorter periods to diagnosis, presents increased rates of neurologic deficit, surgical intervention, and complications.
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ISSN:2474-7661
2474-7661
DOI:10.5435/JAAOSGlobal-D-22-00178