Non-specific spondylodiscitis: a new perspective for surgical treatment.
Antibiotic treatment of spondylodiscitis
ESR, CRP
Non-specific spondylodiscitis
Pyogenic spondylodiscitis
Vertebral osteomyelitis
Journal
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
11
06
2021
accepted:
24
11
2021
revised:
10
10
2021
pubmed:
16
1
2022
medline:
7
4
2022
entrez:
15
1
2022
Statut:
ppublish
Résumé
Pyogenic spondylodiscitis is a relatively rare spinal disease; non-specific spondylodiscitis (NSS) cases are increasing. This study aims to identify if changes of inflammatory markers under antibiotic therapy can be used to determine which NSS patients can benefit from surgical indication earlier than others. Two groups of patients with NSS were examined. Group A underwent surgery, while Group B was treated conservatively. Group B was also subdivided in patients undergoing antibiotic therapy for > 6 weeks (B1) and < 6 weeks (B2). Groups were compared for age, gender, BMI, blood levels of ESR and CRP and VAS scale. There were no differences (P = 0.06) in reduction in ESR at 4 weeks between two main groups. A reduction in CRP, with < 2.7 mg/dl at 4 weeks, was observed in Group A (P = 0.01). Comparing Group B1 to B2, a reduction (P = 0.0001) in VAS, ESR and CRP at 4 weeks was observed in Group B2. It was possible to isolate the pathogen in 52.8% of Group B, without any differences on VAS, ESR and CRP values and on length of the antibiotic therapy. The surgical treatment should be considered for patients who, after 4 weeks of conservative therapy, do not show a reduction in the ESR < 50 mm/h and of the CRP < 2.7 g/dl. The comparison between groups underwent surgically and those treated conservatively showed a reduction in the CRP at 4 weeks and better VAS for pain at 3 months in Group A.
Identifiants
pubmed: 35031861
doi: 10.1007/s00586-021-07072-z
pii: 10.1007/s00586-021-07072-z
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
461-472Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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