When and how to operate on spondylodiscitis: a report of 13 patients View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-07-20

AUTHORS

Andreas F. Mavrogenis, Vasilis Igoumenou, Konstantinos Tsiavos, Panayiotis Megaloikonomos, Georgios N. Panagopoulos, Christos Vottis, Efthymia Giannitsioti, Antonios Papadopoulos, Konstantinos C. Soultanis

ABSTRACT

PurposeConflicting reports exist regarding the surgical indications, timing, approach, staged or not operation, and spinal instrumentation for patients with spondylodiscitis. Therefore, we performed this study to evaluate the outcome of a series of patients with spondylodiscitis aiming to answer when and how to operate on these patients.Materials and methodsWe retrospectively studied the files of 153 patients with spondylodiscitis treated at our institution from 2002 to 2012. The approach included MR imaging of the infected spine, isolation of the pathogen with blood cultures and/or biopsy, and further conservative or surgical treatment. The mean follow-up was 6 years (range 1–13 years). We evaluated the indications, timing (when), and methods (how) for surgical treatment, and the clinical outcome of these patients.ResultsOrthopedic surgical treatment was necessary for 13 of the 153 patients (8.5 %). These were patients with low access to healthcare systems because of low socioeconomic status, third-country migrants, prisoners or intravenous drug use, patients in whom a bacterial isolate documentation was necessary, and patients with previous spinal operations. The most common pathogen was Mycobacterium tuberculosis. The surgical indications included deterioration of the neurological status (11 patients), need for bacterial isolate (10 patients), septicemia due to no response to antibiotics (five patients), and/or spinal instability (three patients). An anterior vertebral approach was more commonly used. Nine of the 13 patients had spinal instrumentation in the same setting. Improvement or recovery of the neurological status was observed postoperatively in all patients with preoperative neurological deficits. Postoperatively, two patients deceased from pulmonary infection and septicemia, and heart infarction. At the last follow-up, patients who were alive were asymptomatic; ten patients were neurologically intact, and one patient experienced paraparesis. Imaging showed spinal fusion, without evidence of recurrent spondylodiscitis. Complications related to the spinal instrumentation were not observed in the respective patients.ConclusionsConservative treatment is the standard for spondylodiscitis. Physicians should be alert for Mycobacterium tuberculosis spondylitis because of the low access to healthcare systems of patients with low social and economic status. Surgical indications include obtaining tissue sample for diagnosis, occurrence or progression of neurological symptoms, failure of conservative treatment, large anterior abscesses, and very extensive disease. Thorough debridement of infected tissue and spinal stability is paramount. The anterior approach provides direct access and improved exposure to the most commonly affected part of the spine. Spinal instrumentation is generally recommended for optimum spinal stability and fusion, without any implant-related complications. More... »

PAGES

31-40

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00590-015-1674-6

DOI

http://dx.doi.org/10.1007/s00590-015-1674-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1012825516

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26190644


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1103", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Clinical Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Adult", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Aged", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Anti-Bacterial Agents", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Biopsy", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Candida albicans", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Candidiasis, Invasive", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Clinical Decision-Making", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Debridement", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Discitis", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Follow-Up Studies", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Gram-Negative Bacteria", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Gram-Negative Bacterial Infections", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Gram-Positive Bacteria", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Gram-Positive Bacterial Infections", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Humans", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Magnetic Resonance Imaging", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Male", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Middle Aged", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Nervous System Diseases", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Retrospective Studies", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Tomography, X-Ray Computed", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Treatment Outcome", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Tuberculosis, Spinal", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "alternateName": "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece", 
          "id": "http://www.grid.ac/institutes/grid.5216.0", 
          "name": [
            "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Mavrogenis", 
        "givenName": "Andreas F.", 
        "id": "sg:person.01366422124.48", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01366422124.48"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece", 
          "id": "http://www.grid.ac/institutes/grid.5216.0", 
          "name": [
            "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Igoumenou", 
        "givenName": "Vasilis", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece", 
          "id": "http://www.grid.ac/institutes/grid.5216.0", 
          "name": [
            "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Tsiavos", 
        "givenName": "Konstantinos", 
        "id": "sg:person.0757040221.41", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0757040221.41"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece", 
          "id": "http://www.grid.ac/institutes/grid.5216.0", 
          "name": [
            "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Megaloikonomos", 
        "givenName": "Panayiotis", 
        "id": "sg:person.0662620231.49", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0662620231.49"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece", 
          "id": "http://www.grid.ac/institutes/grid.5216.0", 
          "name": [
            "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Panagopoulos", 
        "givenName": "Georgios N.", 
        "id": "sg:person.01006125401.72", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01006125401.72"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece", 
          "id": "http://www.grid.ac/institutes/grid.5216.0", 
          "name": [
            "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Vottis", 
        "givenName": "Christos", 
        "id": "sg:person.01003260556.34", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01003260556.34"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Fourth Department of Internal Medicine, ATTIKON University General Hospital, Athens University Medical School, Athens, Greece", 
          "id": "http://www.grid.ac/institutes/grid.5216.0", 
          "name": [
            "Fourth Department of Internal Medicine, ATTIKON University General Hospital, Athens University Medical School, Athens, Greece"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Giannitsioti", 
        "givenName": "Efthymia", 
        "id": "sg:person.01325460113.34", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01325460113.34"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Fourth Department of Internal Medicine, ATTIKON University General Hospital, Athens University Medical School, Athens, Greece", 
          "id": "http://www.grid.ac/institutes/grid.5216.0", 
          "name": [
            "Fourth Department of Internal Medicine, ATTIKON University General Hospital, Athens University Medical School, Athens, Greece"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Papadopoulos", 
        "givenName": "Antonios", 
        "id": "sg:person.01044141261.85", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01044141261.85"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece", 
          "id": "http://www.grid.ac/institutes/grid.5216.0", 
          "name": [
            "First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Soultanis", 
        "givenName": "Konstantinos C.", 
        "id": "sg:person.0774041721.27", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0774041721.27"
        ], 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "sg:pub.10.1007/s00264-006-0188-6", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1032657716", 
          "https://doi.org/10.1007/s00264-006-0188-6"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/pl00011954", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1002440756", 
          "https://doi.org/10.1007/pl00011954"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00590-013-1239-5", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1003922831", 
          "https://doi.org/10.1007/s00590-013-1239-5"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1471-2334-14-226", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1052653905", 
          "https://doi.org/10.1186/1471-2334-14-226"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00586-004-0699-z", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1026626132", 
          "https://doi.org/10.1007/s00586-004-0699-z"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00586-006-0251-4", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1010688643", 
          "https://doi.org/10.1007/s00586-006-0251-4"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00264-011-1441-1", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1035508648", 
          "https://doi.org/10.1007/s00264-011-1441-1"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2015-07-20", 
    "datePublishedReg": "2015-07-20", 
    "description": "PurposeConflicting reports exist regarding the surgical indications, timing, approach, staged or not operation, and spinal instrumentation for patients with spondylodiscitis. Therefore, we performed this study to evaluate the outcome of a series of patients with spondylodiscitis aiming to answer when and how to operate on these patients.Materials and methodsWe retrospectively studied the files of 153 patients with spondylodiscitis treated at our institution from 2002 to 2012. The approach included MR imaging of the infected spine, isolation of the pathogen with blood cultures and/or biopsy, and further conservative or surgical treatment. The mean follow-up was 6\u00a0years (range 1\u201313\u00a0years). We evaluated the indications, timing (when), and methods (how) for surgical treatment, and the clinical outcome of these patients.ResultsOrthopedic surgical treatment was necessary for 13 of the 153 patients (8.5\u00a0%). These were patients with low access to healthcare systems because of low socioeconomic status, third-country migrants, prisoners or intravenous drug use, patients in whom a bacterial isolate documentation was necessary, and patients with previous spinal operations. The most common pathogen was Mycobacterium tuberculosis. The surgical indications included deterioration of the neurological status (11 patients), need for bacterial isolate (10 patients), septicemia due to no response to antibiotics (five patients), and/or spinal instability (three patients). An anterior vertebral approach was more commonly used. Nine of the 13 patients had spinal instrumentation in the same setting. Improvement or recovery of the neurological status was observed postoperatively in all patients with preoperative neurological deficits. Postoperatively, two patients deceased from pulmonary infection and septicemia, and heart infarction. At the last follow-up, patients who were alive were asymptomatic; ten patients were neurologically intact, and one patient experienced paraparesis. Imaging showed spinal fusion, without evidence of recurrent spondylodiscitis. Complications related to the spinal instrumentation were not observed in the respective patients.ConclusionsConservative treatment is the standard for spondylodiscitis. Physicians should be alert for Mycobacterium tuberculosis spondylitis because of the low access to healthcare systems of patients with low social and economic status. Surgical indications include obtaining tissue sample for diagnosis, occurrence or progression of neurological symptoms, failure of conservative treatment, large anterior abscesses, and very extensive disease. Thorough debridement of infected tissue and spinal stability is paramount. The anterior approach provides direct access and improved exposure to the most commonly affected part of the spine. Spinal instrumentation is generally recommended for optimum spinal stability and fusion, without any implant-related complications.", 
    "genre": "article", 
    "id": "sg:pub.10.1007/s00590-015-1674-6", 
    "isAccessibleForFree": false, 
    "isPartOf": [
      {
        "id": "sg:journal.1114904", 
        "issn": [
          "1633-8065", 
          "1432-1068"
        ], 
        "name": "European Journal of Orthopaedic Surgery & Traumatology", 
        "publisher": "Springer Nature", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "1", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "26"
      }
    ], 
    "keywords": [
      "surgical indications", 
      "surgical treatment", 
      "spinal instrumentation", 
      "neurological status", 
      "spinal stability", 
      "previous spinal operations", 
      "preoperative neurological deficits", 
      "intravenous drug use", 
      "implant-related complications", 
      "series of patients", 
      "healthcare system", 
      "low socioeconomic status", 
      "ConclusionsConservative treatment", 
      "tuberculosis spondylitis", 
      "anterior abscesses", 
      "extensive disease", 
      "neurological deficits", 
      "pulmonary infection", 
      "conservative treatment", 
      "anterior approach", 
      "clinical outcomes", 
      "neurological symptoms", 
      "thorough debridement", 
      "infected spine", 
      "blood cultures", 
      "low access", 
      "spondylodiscitis", 
      "spinal fusion", 
      "respective patients", 
      "spinal operations", 
      "common pathogens", 
      "spinal instability", 
      "patients", 
      "heart infarction", 
      "drug use", 
      "MR imaging", 
      "Mycobacterium tuberculosis", 
      "socioeconomic status", 
      "tissue samples", 
      "complications", 
      "treatment", 
      "septicemia", 
      "infected tissues", 
      "indications", 
      "spine", 
      "status", 
      "outcomes", 
      "same setting", 
      "economic status", 
      "bacterial isolates", 
      "report", 
      "paraparesis", 
      "abscess", 
      "debridement", 
      "infarction", 
      "spondylitis", 
      "biopsy", 
      "pathogens", 
      "symptoms", 
      "tuberculosis", 
      "infection", 
      "MethodsWe", 
      "physicians", 
      "disease", 
      "diagnosis", 
      "progression", 
      "antibiotics", 
      "tissue", 
      "deficits", 
      "exposure", 
      "timing", 
      "imaging", 
      "isolates", 
      "failure", 
      "years", 
      "access", 
      "setting", 
      "deterioration", 
      "response", 
      "evidence", 
      "fusion", 
      "instrumentation", 
      "recovery", 
      "study", 
      "occurrence", 
      "direct access", 
      "improvement", 
      "documentation", 
      "culture", 
      "use", 
      "third-country migrants", 
      "isolation", 
      "samples", 
      "institutions", 
      "prisoners", 
      "standards", 
      "approach", 
      "series", 
      "operation", 
      "files", 
      "part", 
      "system", 
      "instability", 
      "method", 
      "materials", 
      "migrants", 
      "stability"
    ], 
    "name": "When and how to operate on spondylodiscitis: a report of 13 patients", 
    "pagination": "31-40", 
    "productId": [
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1012825516"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1007/s00590-015-1674-6"
        ]
      }, 
      {
        "name": "pubmed_id", 
        "type": "PropertyValue", 
        "value": [
          "26190644"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1007/s00590-015-1674-6", 
      "https://app.dimensions.ai/details/publication/pub.1012825516"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2022-12-01T06:33", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-springernature-scigraph/baseset/20221201/entities/gbq_results/article/article_655.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "https://doi.org/10.1007/s00590-015-1674-6"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s00590-015-1674-6'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s00590-015-1674-6'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s00590-015-1674-6'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s00590-015-1674-6'


 

This table displays all metadata directly associated to this object as RDF triples.

345 TRIPLES      21 PREDICATES      162 URIs      147 LITERALS      30 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1007/s00590-015-1674-6 schema:about N1c81e56ff56943259587073827a13e38
2 N2413610c19bc4fefaa48db400bc52a2c
3 N2753cb018d574741b5b9bfc82d17fc5e
4 N2c912c695de14d068f1495ce82e7051a
5 N33b15e3c430b4bd0bf506b540d91668b
6 N37d99b8a49e949dca82f6928838f9bd4
7 N5bf861262460488693f6f049cb16ac7a
8 N5ccf225d69b74dd7a576357351931f28
9 N5f88e4184bf54029995e3a8930ed9642
10 N60da55ab221a46b38f7a028267d7bd62
11 N83a0703d917e4d16bbb1ac3403d4425b
12 N83bb95efedbd4531807805b493a524e8
13 N84626df7d6e141e7bbbe212ecddcfc02
14 N8a2aa6fdaf3f461eb29f6ee8e4e46f66
15 Na1d8aeae169d47e5af39e303a43dbc97
16 Na68134beb1b945af982a0ac69432f332
17 Nbd5df02e5fb647a5af49b6dbb49b1f9b
18 Nbde0b037cb444e68baa77a0ade9c5fce
19 Nc4f624d234eb4580b02dd44f05d64395
20 Nd349ca0761044dfe918cc997f87c826d
21 Ndc789bf949cc4cedb067e40e693f9dd6
22 Ne07c11ded379472f953171636ee60b4f
23 Nf1393509b0514f258f45f34e7040e36d
24 anzsrc-for:11
25 anzsrc-for:1103
26 schema:author Ne397470f32394f8aa74d4b4ef82e328a
27 schema:citation sg:pub.10.1007/pl00011954
28 sg:pub.10.1007/s00264-006-0188-6
29 sg:pub.10.1007/s00264-011-1441-1
30 sg:pub.10.1007/s00586-004-0699-z
31 sg:pub.10.1007/s00586-006-0251-4
32 sg:pub.10.1007/s00590-013-1239-5
33 sg:pub.10.1186/1471-2334-14-226
34 schema:datePublished 2015-07-20
35 schema:datePublishedReg 2015-07-20
36 schema:description PurposeConflicting reports exist regarding the surgical indications, timing, approach, staged or not operation, and spinal instrumentation for patients with spondylodiscitis. Therefore, we performed this study to evaluate the outcome of a series of patients with spondylodiscitis aiming to answer when and how to operate on these patients.Materials and methodsWe retrospectively studied the files of 153 patients with spondylodiscitis treated at our institution from 2002 to 2012. The approach included MR imaging of the infected spine, isolation of the pathogen with blood cultures and/or biopsy, and further conservative or surgical treatment. The mean follow-up was 6 years (range 1–13 years). We evaluated the indications, timing (when), and methods (how) for surgical treatment, and the clinical outcome of these patients.ResultsOrthopedic surgical treatment was necessary for 13 of the 153 patients (8.5 %). These were patients with low access to healthcare systems because of low socioeconomic status, third-country migrants, prisoners or intravenous drug use, patients in whom a bacterial isolate documentation was necessary, and patients with previous spinal operations. The most common pathogen was Mycobacterium tuberculosis. The surgical indications included deterioration of the neurological status (11 patients), need for bacterial isolate (10 patients), septicemia due to no response to antibiotics (five patients), and/or spinal instability (three patients). An anterior vertebral approach was more commonly used. Nine of the 13 patients had spinal instrumentation in the same setting. Improvement or recovery of the neurological status was observed postoperatively in all patients with preoperative neurological deficits. Postoperatively, two patients deceased from pulmonary infection and septicemia, and heart infarction. At the last follow-up, patients who were alive were asymptomatic; ten patients were neurologically intact, and one patient experienced paraparesis. Imaging showed spinal fusion, without evidence of recurrent spondylodiscitis. Complications related to the spinal instrumentation were not observed in the respective patients.ConclusionsConservative treatment is the standard for spondylodiscitis. Physicians should be alert for Mycobacterium tuberculosis spondylitis because of the low access to healthcare systems of patients with low social and economic status. Surgical indications include obtaining tissue sample for diagnosis, occurrence or progression of neurological symptoms, failure of conservative treatment, large anterior abscesses, and very extensive disease. Thorough debridement of infected tissue and spinal stability is paramount. The anterior approach provides direct access and improved exposure to the most commonly affected part of the spine. Spinal instrumentation is generally recommended for optimum spinal stability and fusion, without any implant-related complications.
37 schema:genre article
38 schema:isAccessibleForFree false
39 schema:isPartOf N70ad1fba83bd46efa5794efabe13198f
40 N74483121770a4ad79dfa19b464129122
41 sg:journal.1114904
42 schema:keywords ConclusionsConservative treatment
43 MR imaging
44 MethodsWe
45 Mycobacterium tuberculosis
46 abscess
47 access
48 anterior abscesses
49 anterior approach
50 antibiotics
51 approach
52 bacterial isolates
53 biopsy
54 blood cultures
55 clinical outcomes
56 common pathogens
57 complications
58 conservative treatment
59 culture
60 debridement
61 deficits
62 deterioration
63 diagnosis
64 direct access
65 disease
66 documentation
67 drug use
68 economic status
69 evidence
70 exposure
71 extensive disease
72 failure
73 files
74 fusion
75 healthcare system
76 heart infarction
77 imaging
78 implant-related complications
79 improvement
80 indications
81 infarction
82 infected spine
83 infected tissues
84 infection
85 instability
86 institutions
87 instrumentation
88 intravenous drug use
89 isolates
90 isolation
91 low access
92 low socioeconomic status
93 materials
94 method
95 migrants
96 neurological deficits
97 neurological status
98 neurological symptoms
99 occurrence
100 operation
101 outcomes
102 paraparesis
103 part
104 pathogens
105 patients
106 physicians
107 preoperative neurological deficits
108 previous spinal operations
109 prisoners
110 progression
111 pulmonary infection
112 recovery
113 report
114 respective patients
115 response
116 same setting
117 samples
118 septicemia
119 series
120 series of patients
121 setting
122 socioeconomic status
123 spinal fusion
124 spinal instability
125 spinal instrumentation
126 spinal operations
127 spinal stability
128 spine
129 spondylitis
130 spondylodiscitis
131 stability
132 standards
133 status
134 study
135 surgical indications
136 surgical treatment
137 symptoms
138 system
139 third-country migrants
140 thorough debridement
141 timing
142 tissue
143 tissue samples
144 treatment
145 tuberculosis
146 tuberculosis spondylitis
147 use
148 years
149 schema:name When and how to operate on spondylodiscitis: a report of 13 patients
150 schema:pagination 31-40
151 schema:productId N005a0dcd5aad479db00812db2c934656
152 Nd8df158d80054a53b71a29884e6b1615
153 Nfe18acaabbe84f1399a9765b40252091
154 schema:sameAs https://app.dimensions.ai/details/publication/pub.1012825516
155 https://doi.org/10.1007/s00590-015-1674-6
156 schema:sdDatePublished 2022-12-01T06:33
157 schema:sdLicense https://scigraph.springernature.com/explorer/license/
158 schema:sdPublisher N52c7bd3a035e46829b19e59c626efb97
159 schema:url https://doi.org/10.1007/s00590-015-1674-6
160 sgo:license sg:explorer/license/
161 sgo:sdDataset articles
162 rdf:type schema:ScholarlyArticle
163 N005a0dcd5aad479db00812db2c934656 schema:name doi
164 schema:value 10.1007/s00590-015-1674-6
165 rdf:type schema:PropertyValue
166 N0aed66387bea4a65a909cf1e3a5c6c46 rdf:first Ne22a4787db7546838f4741f81b094bcc
167 rdf:rest N557663aff24a423daa4999bd7b3cd05a
168 N0d8266d3c3814782a3dfb7f9ccd0bbd1 rdf:first sg:person.0774041721.27
169 rdf:rest rdf:nil
170 N1c81e56ff56943259587073827a13e38 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
171 schema:name Nervous System Diseases
172 rdf:type schema:DefinedTerm
173 N2413610c19bc4fefaa48db400bc52a2c schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
174 schema:name Clinical Decision-Making
175 rdf:type schema:DefinedTerm
176 N2753cb018d574741b5b9bfc82d17fc5e schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
177 schema:name Humans
178 rdf:type schema:DefinedTerm
179 N2c912c695de14d068f1495ce82e7051a schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
180 schema:name Discitis
181 rdf:type schema:DefinedTerm
182 N33b15e3c430b4bd0bf506b540d91668b schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
183 schema:name Anti-Bacterial Agents
184 rdf:type schema:DefinedTerm
185 N37d99b8a49e949dca82f6928838f9bd4 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
186 schema:name Biopsy
187 rdf:type schema:DefinedTerm
188 N3ab9c79a1f324a8db5397dcf8adc7321 rdf:first sg:person.01325460113.34
189 rdf:rest Na2896b79b14649cea1b9fe2123923dfe
190 N52c7bd3a035e46829b19e59c626efb97 schema:name Springer Nature - SN SciGraph project
191 rdf:type schema:Organization
192 N557663aff24a423daa4999bd7b3cd05a rdf:first sg:person.0757040221.41
193 rdf:rest Nd917c5895b7842a7b9254080250ea709
194 N5bf861262460488693f6f049cb16ac7a schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
195 schema:name Gram-Positive Bacteria
196 rdf:type schema:DefinedTerm
197 N5ccf225d69b74dd7a576357351931f28 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
198 schema:name Gram-Negative Bacterial Infections
199 rdf:type schema:DefinedTerm
200 N5f88e4184bf54029995e3a8930ed9642 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
201 schema:name Retrospective Studies
202 rdf:type schema:DefinedTerm
203 N60da55ab221a46b38f7a028267d7bd62 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
204 schema:name Magnetic Resonance Imaging
205 rdf:type schema:DefinedTerm
206 N675fedb0cd42408ea775975736355bda rdf:first sg:person.01006125401.72
207 rdf:rest N92fe157977b1415cb577b88d8f750201
208 N70ad1fba83bd46efa5794efabe13198f schema:issueNumber 1
209 rdf:type schema:PublicationIssue
210 N74483121770a4ad79dfa19b464129122 schema:volumeNumber 26
211 rdf:type schema:PublicationVolume
212 N83a0703d917e4d16bbb1ac3403d4425b schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
213 schema:name Debridement
214 rdf:type schema:DefinedTerm
215 N83bb95efedbd4531807805b493a524e8 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
216 schema:name Follow-Up Studies
217 rdf:type schema:DefinedTerm
218 N84626df7d6e141e7bbbe212ecddcfc02 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
219 schema:name Adult
220 rdf:type schema:DefinedTerm
221 N8a2aa6fdaf3f461eb29f6ee8e4e46f66 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
222 schema:name Treatment Outcome
223 rdf:type schema:DefinedTerm
224 N92fe157977b1415cb577b88d8f750201 rdf:first sg:person.01003260556.34
225 rdf:rest N3ab9c79a1f324a8db5397dcf8adc7321
226 Na1d8aeae169d47e5af39e303a43dbc97 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
227 schema:name Male
228 rdf:type schema:DefinedTerm
229 Na2896b79b14649cea1b9fe2123923dfe rdf:first sg:person.01044141261.85
230 rdf:rest N0d8266d3c3814782a3dfb7f9ccd0bbd1
231 Na68134beb1b945af982a0ac69432f332 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
232 schema:name Candidiasis, Invasive
233 rdf:type schema:DefinedTerm
234 Nbd5df02e5fb647a5af49b6dbb49b1f9b schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
235 schema:name Aged
236 rdf:type schema:DefinedTerm
237 Nbde0b037cb444e68baa77a0ade9c5fce schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
238 schema:name Candida albicans
239 rdf:type schema:DefinedTerm
240 Nc4f624d234eb4580b02dd44f05d64395 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
241 schema:name Gram-Negative Bacteria
242 rdf:type schema:DefinedTerm
243 Nd349ca0761044dfe918cc997f87c826d schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
244 schema:name Middle Aged
245 rdf:type schema:DefinedTerm
246 Nd8df158d80054a53b71a29884e6b1615 schema:name dimensions_id
247 schema:value pub.1012825516
248 rdf:type schema:PropertyValue
249 Nd917c5895b7842a7b9254080250ea709 rdf:first sg:person.0662620231.49
250 rdf:rest N675fedb0cd42408ea775975736355bda
251 Ndc789bf949cc4cedb067e40e693f9dd6 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
252 schema:name Tomography, X-Ray Computed
253 rdf:type schema:DefinedTerm
254 Ne07c11ded379472f953171636ee60b4f schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
255 schema:name Tuberculosis, Spinal
256 rdf:type schema:DefinedTerm
257 Ne22a4787db7546838f4741f81b094bcc schema:affiliation grid-institutes:grid.5216.0
258 schema:familyName Igoumenou
259 schema:givenName Vasilis
260 rdf:type schema:Person
261 Ne397470f32394f8aa74d4b4ef82e328a rdf:first sg:person.01366422124.48
262 rdf:rest N0aed66387bea4a65a909cf1e3a5c6c46
263 Nf1393509b0514f258f45f34e7040e36d schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
264 schema:name Gram-Positive Bacterial Infections
265 rdf:type schema:DefinedTerm
266 Nfe18acaabbe84f1399a9765b40252091 schema:name pubmed_id
267 schema:value 26190644
268 rdf:type schema:PropertyValue
269 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
270 schema:name Medical and Health Sciences
271 rdf:type schema:DefinedTerm
272 anzsrc-for:1103 schema:inDefinedTermSet anzsrc-for:
273 schema:name Clinical Sciences
274 rdf:type schema:DefinedTerm
275 sg:journal.1114904 schema:issn 1432-1068
276 1633-8065
277 schema:name European Journal of Orthopaedic Surgery & Traumatology
278 schema:publisher Springer Nature
279 rdf:type schema:Periodical
280 sg:person.01003260556.34 schema:affiliation grid-institutes:grid.5216.0
281 schema:familyName Vottis
282 schema:givenName Christos
283 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01003260556.34
284 rdf:type schema:Person
285 sg:person.01006125401.72 schema:affiliation grid-institutes:grid.5216.0
286 schema:familyName Panagopoulos
287 schema:givenName Georgios N.
288 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01006125401.72
289 rdf:type schema:Person
290 sg:person.01044141261.85 schema:affiliation grid-institutes:grid.5216.0
291 schema:familyName Papadopoulos
292 schema:givenName Antonios
293 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01044141261.85
294 rdf:type schema:Person
295 sg:person.01325460113.34 schema:affiliation grid-institutes:grid.5216.0
296 schema:familyName Giannitsioti
297 schema:givenName Efthymia
298 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01325460113.34
299 rdf:type schema:Person
300 sg:person.01366422124.48 schema:affiliation grid-institutes:grid.5216.0
301 schema:familyName Mavrogenis
302 schema:givenName Andreas F.
303 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01366422124.48
304 rdf:type schema:Person
305 sg:person.0662620231.49 schema:affiliation grid-institutes:grid.5216.0
306 schema:familyName Megaloikonomos
307 schema:givenName Panayiotis
308 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0662620231.49
309 rdf:type schema:Person
310 sg:person.0757040221.41 schema:affiliation grid-institutes:grid.5216.0
311 schema:familyName Tsiavos
312 schema:givenName Konstantinos
313 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0757040221.41
314 rdf:type schema:Person
315 sg:person.0774041721.27 schema:affiliation grid-institutes:grid.5216.0
316 schema:familyName Soultanis
317 schema:givenName Konstantinos C.
318 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0774041721.27
319 rdf:type schema:Person
320 sg:pub.10.1007/pl00011954 schema:sameAs https://app.dimensions.ai/details/publication/pub.1002440756
321 https://doi.org/10.1007/pl00011954
322 rdf:type schema:CreativeWork
323 sg:pub.10.1007/s00264-006-0188-6 schema:sameAs https://app.dimensions.ai/details/publication/pub.1032657716
324 https://doi.org/10.1007/s00264-006-0188-6
325 rdf:type schema:CreativeWork
326 sg:pub.10.1007/s00264-011-1441-1 schema:sameAs https://app.dimensions.ai/details/publication/pub.1035508648
327 https://doi.org/10.1007/s00264-011-1441-1
328 rdf:type schema:CreativeWork
329 sg:pub.10.1007/s00586-004-0699-z schema:sameAs https://app.dimensions.ai/details/publication/pub.1026626132
330 https://doi.org/10.1007/s00586-004-0699-z
331 rdf:type schema:CreativeWork
332 sg:pub.10.1007/s00586-006-0251-4 schema:sameAs https://app.dimensions.ai/details/publication/pub.1010688643
333 https://doi.org/10.1007/s00586-006-0251-4
334 rdf:type schema:CreativeWork
335 sg:pub.10.1007/s00590-013-1239-5 schema:sameAs https://app.dimensions.ai/details/publication/pub.1003922831
336 https://doi.org/10.1007/s00590-013-1239-5
337 rdf:type schema:CreativeWork
338 sg:pub.10.1186/1471-2334-14-226 schema:sameAs https://app.dimensions.ai/details/publication/pub.1052653905
339 https://doi.org/10.1186/1471-2334-14-226
340 rdf:type schema:CreativeWork
341 grid-institutes:grid.5216.0 schema:alternateName First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece
342 Fourth Department of Internal Medicine, ATTIKON University General Hospital, Athens University Medical School, Athens, Greece
343 schema:name First Department of Orthopaedics, ATTIKON University General Hospital, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece
344 Fourth Department of Internal Medicine, ATTIKON University General Hospital, Athens University Medical School, Athens, Greece
345 rdf:type schema:Organization
 




Preview window. Press ESC to close (or click here)


...