Postoperative Spondylodiskitis: Etiology, Clinical Findings, Prognosis, and Comparison with Nonoperative Pyogenic Spondylodiskitis

We studied 31 cases of postoperative pyogenic spondylodiskitis (POS), comparing them with 72 cases of nonpostoperative pyogenic spondylodiskitis (NPOS). POS represents 30.1% of cases of pyogenic spondylodiskitis. The onset of symptoms occurred an average (±SD) of 27.7 (± 25.3) days following surgery...

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Bibliographic Details
Published in:	Clinical infectious diseases Vol. 29; no. 2; pp. 339 - 345
Main Authors:	Jiménez-Mejías, Manuel E., de Dios Colmenero, Juan, Sánchez-Lora, Fernando J., Palomino-Nicás, Julián, Reguera, José M., García de la Heras, Joaquín, García-Ordoñez, María A., Pachón, Jerónimo
Format:	Journal Article Conference Proceeding
Language:	English
Published:	Chicago, IL The University of Chicago Press 01-08-1999 University of Chicago Press
Subjects:	Abscesses Adolescent Adult Aged Biological and medical sciences Biopsies Blood Bones Clinical Articles Discitis Discitis - drug therapy Discitis - microbiology Discitis - physiopathology Erythrocyte sedimentation rate Etiology Female Humans Infections Male Medical sciences Middle Aged Orthopedic surgery Prognosis Spine - surgery Staphylococcus Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Wound Infection - drug therapy Surgical Wound Infection - microbiology Surgical Wound Infection - physiopathology Symptoms Human Postoperative Prognosis Spine Diseases of the osteoarticular system Spine disease Infection Spondylitis Symptomatology Microbiological investigation Etiology Surgery Bacteriosis Complication Comparative study
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Summary:	We studied 31 cases of postoperative pyogenic spondylodiskitis (POS), comparing them with 72 cases of nonpostoperative pyogenic spondylodiskitis (NPOS). POS represents 30.1% of cases of pyogenic spondylodiskitis. The onset of symptoms occurred an average (±SD) of 27.7 (± 25.3) days following surgery. Predisposing factors were less frequent in POS than NPOS cases (P = .002). Neurological complications and inflammatory signs in the spine were more frequent with POS than with NPOS (P = .002 and P < .00001). Coagulase-negative Staphylococcus and anaerobic bacteria were more frequent in POS than in NPOS (P = .0001 and P = .05). Percutaneous bone biopsies yielded the etiology in 66.7% of cases, open bone biopsies in 100%, blood cultures in 55.6%, and cultures of adjacent foci in 94.4%. Eleven patients (35.5%) were cured with antimicrobial treatment, but surgical treatment was necessary in 64.5%. No relapses or deaths were recorded. Seventeen patients (54.8%) had severe functional sequelae, which were associated with inflammatory signs in the spine (P = .033), higher levels of leukocytosis (P = .05), higher erythrocyte sedimentation rates (P = .05), and paravertebral abscesses (P = .04).
Bibliography:	ark:/67375/HXZ-0J8VKP0Q-K istex:72BCDA7619FAD4A27B352ED1754F51DC0B3598DA ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1058-4838 1537-6591
DOI:	10.1086/520212