Spinal infection: state of the art and management algorithm
Top Cited Papers
- 12 June 2013
- journal article
- review article
- Published by Springer Science and Business Media LLC in European Spine Journal
- Vol. 22 (12), 2787-2799
- https://doi.org/10.1007/s00586-013-2850-1
Abstract
Spinal infection is a rare pathology although a concerning rising incidence has been observed in recent years. This increase might reflect a progressively more susceptible population but also the availability of increased diagnostic accuracy. Yet, even with improved diagnosis tools and procedures, the delay in diagnosis remains an important issue. This review aims to highlight the importance of a methodological attitude towards accurate and prompt diagnosis using an algorithm to aid on spinal infection management. Appropriate literature on spinal infection was selected using databases from the US National Library of Medicine and the National Institutes of Health. Literature reveals that histopathological analysis of infected tissues is a paramount for diagnosis and must be performed routinely. Antibiotic therapy is transversal to both conservative and surgical approaches and must be initiated after etiological diagnosis. Indications for surgical treatment include neurological deficits or sepsis, spine instability and/or deformity, presence of epidural abscess and upon failure of conservative treatment. A methodological assessment could lead to diagnosis effectiveness of spinal infection. Towards this, we present a management algorithm based on literature findings.Keywords
This publication has 111 references indexed in Scilit:
- Treatment of spondylodiscitisInternational Orthopaedics, 2011
- Spinal infections in children: a reviewInternational Orthopaedics, 2011
- Single stage anterior reconstruction using titanium mesh cages in neglected kyphotic tuberculous spondylodiscitis of the cervical spineEuropean Spine Journal, 2010
- The results of simultaneous posterior–anterior–posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosisEuropean Spine Journal, 2010
- Surgical treatment of infectious spondylitis in patients undergoing hemodialysis therapyEuropean Spine Journal, 2010
- Septic hematogenous lumbar spondylodiscitis in elderly patients with multiple risk factors: efficacy of posterior stabilization and interbody fusion with iliac crest bone graftEuropean Spine Journal, 2010
- Expanding role of 18F-fluoro-d-deoxyglucose PET and PET/CT in spinal infectionsEuropean Spine Journal, 2010
- The use of RhBMP-2 in single-level transforaminal lumbar interbody fusion: a clinical and radiographic analysisEuropean Spine Journal, 2009
- Surgical treatment of pyogenic vertebral osteomyelitis with spinal instrumentationEuropean Spine Journal, 2006
- Long-term results of ventro-dorsal versus ventral instrumentation fusion in the treatment of spondylitisInternational Orthopaedics, 2006