The Efficacy of Daily Local Antibiotic Lavage via an Epidural Suction-Irrigation Drainage Technique in Spondylodiscitis and Isolated Spinal Epidural Empyema: A 20-Year Experience of a Single Spine Center.
complications
epidural suction–irrigation drainage
isolated spinal epidural empyema
relapse
spondylodiscitis
surgical site infection
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
02 Aug 2023
02 Aug 2023
Historique:
received:
08
07
2023
revised:
29
07
2023
accepted:
31
07
2023
medline:
12
8
2023
pubmed:
12
8
2023
entrez:
12
8
2023
Statut:
epublish
Résumé
Various treatment modalities are available for local antibiotic therapy in spondylodiscitis (SD) and isolated spinal epidural empyema (ISEE), but there is no evidence-based recommendation. Postoperative epidural suction-irrigation drainage (ESID) is thought to reduce bacterial load, which may prevent the development of relapse, wound healing, hematogenous spread, and systemic complications. We evaluated the efficacy of postoperative ESID over 20 years on disease progression and outcome in SD and ISEE. Detailed demographic, clinical, imaging, laboratory, and microbiological characteristics were examined in our cohorts of 208 SD and ISEE patients treated with and without ESID at a university spine center in Germany between 2002 and 2022. Between-group comparisons were performed to identify meaningful differences for the procedure. We included data from 208 patients (142 SD, 68.3% vs. 66 ISEE, 31.7%) of whom 146 were ESID patients (87 SD, 59.6% vs. 59 ISEE, 40.4%) and 62 were NON-ESID patients (55 SD, 88.7% vs. 7 ISEE, 11.3%). ESID patients with SD showed more frequent SSI (ESID: 22, 25.3% vs. NON-ESID: 3, 5.5%, Our retrospective cohort study with more than 20 years of experience in ESID technique shows a negative effect in patients with SD in terms of surgical site infections and relapse rate.
Sections du résumé
BACKGROUND
BACKGROUND
Various treatment modalities are available for local antibiotic therapy in spondylodiscitis (SD) and isolated spinal epidural empyema (ISEE), but there is no evidence-based recommendation. Postoperative epidural suction-irrigation drainage (ESID) is thought to reduce bacterial load, which may prevent the development of relapse, wound healing, hematogenous spread, and systemic complications. We evaluated the efficacy of postoperative ESID over 20 years on disease progression and outcome in SD and ISEE.
METHODS
METHODS
Detailed demographic, clinical, imaging, laboratory, and microbiological characteristics were examined in our cohorts of 208 SD and ISEE patients treated with and without ESID at a university spine center in Germany between 2002 and 2022. Between-group comparisons were performed to identify meaningful differences for the procedure.
RESULTS
RESULTS
We included data from 208 patients (142 SD, 68.3% vs. 66 ISEE, 31.7%) of whom 146 were ESID patients (87 SD, 59.6% vs. 59 ISEE, 40.4%) and 62 were NON-ESID patients (55 SD, 88.7% vs. 7 ISEE, 11.3%). ESID patients with SD showed more frequent SSI (ESID: 22, 25.3% vs. NON-ESID: 3, 5.5%,
CONCLUSIONS
CONCLUSIONS
Our retrospective cohort study with more than 20 years of experience in ESID technique shows a negative effect in patients with SD in terms of surgical site infections and relapse rate.
Identifiants
pubmed: 37568480
pii: jcm12155078
doi: 10.3390/jcm12155078
pmc: PMC10420211
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Eur Spine J. 2018 Jul;27(Suppl 3):380-385
pubmed: 28951964
Front Surg. 2023 May 18;10:1200432
pubmed: 37273827
Acta Neurochir (Wien). 2018 Mar;160(3):487-496
pubmed: 29356895
Neurosurg Focus. 2019 Feb 15;46(1):E7
pubmed: 30942997
Orthopade. 2020 Aug;49(8):714-723
pubmed: 32719918
Surg Infect (Larchmt). 2020 Apr;21(3):262-267
pubmed: 31647391
BMC Musculoskelet Disord. 2014 Mar 27;15:105
pubmed: 24669940
Spine (Phila Pa 1976). 2007 Jan 15;32(2):200-6
pubmed: 17224815
Aktuelle Probl Chir Orthop. 1990;34:85-93
pubmed: 1978602
Eur Spine J. 2016 Apr;25(4):1012-20
pubmed: 25895880
BMC Musculoskelet Disord. 2017 Apr 27;18(1):175
pubmed: 28449655
Unfallchirurg. 2007 Mar;110(3):250-4
pubmed: 17043786
Acta Neurochir (Wien). 2005 Feb;147(2):159-66; discussion 166
pubmed: 15570436
Orthopade. 2020 Aug;49(8):691-701
pubmed: 32642943
World Neurosurg. 2014 Dec;82(6):e807-14
pubmed: 24937598
Dtsch Arztebl Int. 2017 Dec 25;114(51-52):875-882
pubmed: 29321098
J Orthop Res. 1996 Sep;14(5):749-54
pubmed: 8893768
J Neurol Surg A Cent Eur Neurosurg. 2014 Nov;75(6):447-52
pubmed: 24554611
Brain Sci. 2021 Jul 30;11(8):
pubmed: 34439638