scholarly journals Editorial Commentary: Pyogenic Vertebral Osteomyelitis and Antimicrobial Therapy: It's Not Just the Length, but Also the Choice

2016 ◽  
Vol 62 (10) ◽  
pp. 1270-1271 ◽  
Author(s):  
Oscar Murillo ◽  
Jaime Lora-Tamayo
Keyword(s):  
Antimicrobial Therapy ◽  
Vertebral Osteomyelitis ◽  
Editorial Commentary ◽  
Pyogenic Vertebral Osteomyelitis

scholarly journals Clinical and Radiological Analysis of Pyogenic Vertebral Osteomyelitis Immediately after Successful Antimicrobial Therapy: Considerations for Assessing Therapeutic Response

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 861
Author(s):  
Ikchan Jeon ◽  
Eunjung Kong ◽  
Dongwoo Yu ◽  
Cheol Pyo Hong
Keyword(s):  
Back Pain ◽  
Clinical Features ◽  
Vertebral Body ◽  
Antimicrobial Therapy ◽  
Fdg Pet ◽  
Therapeutic Response ◽  
Vertebral Osteomyelitis ◽  
Paravertebral Muscle ◽  
Radiological Features ◽  
Pyogenic Vertebral Osteomyelitis

Purpose: The clinical and radiological abnormal findings continue even after successful treatment in pyogenic vertebral osteomyelitis (PVO). We analyzed the clinical and radiological features of cured PVO based on 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (FDG-PET/MRI) and compared the radiological differences between FDG-PET and MRI for assessing therapeutic response in PVO. Methods: This study included 43 patients (28 men and 15 women) with lumbar PVO who had no recurrence after successful antimicrobial therapy. They were divided into two groups based on the location of maximum standardized FDG uptake value (SUVmax) of PVO lesion on FDG-PET/MRI when parenteral antibiotics were discontinued (31 in group A: Intervertebral structure; 12 in group B: Vertebral body and paravertebral muscle). The differences of clinical symptoms, hematological inflammatory indices, and radiological features were retrospectively analyzed. Results: The patients were treated with 42.28 ± 14.58 (21–89) days of parenteral antibiotics. There were significant differences in C-reactive protein (0.97 ± 1.10 vs. 0.51 ± 0.31 mg/dL, p = 0.041; normal range of CRP < 0.5), back pain (4.29 ± 1.13 vs. 3.50 ± 1.00, p = 0.040; visual analog scale), and SUVmax (4.34 ± 1.24 vs. 5.89 ± 1.57, p < 0.001) between the two groups. In the distribution pattern of PVO lesions, FDG-PET overall showed recovery pattern earlier than MRI did (p < 0.001). Conclusions: In cured PVO, the clinical features vary depending on the location of major structural damage of PVO lesion. The involvement of intervertebral structure is related with sustained back pain and elevation of CRP, and vertebral body/paravertebral muscle shows favorable clinical features despite advanced structural damages.

scholarly journals Antimicrobial therapy and assessing therapeutic response in culture-negative pyogenic vertebral osteomyelitis: a retrospective comparative study with culture-positive pyogenic vertebral osteomyelitis

2020 ◽  
Author(s):  
Dongwoo Yu ◽  
Sang Woo Kim ◽  
Ikchan Jeon
Keyword(s):  
Back Pain ◽  
Antimicrobial Therapy ◽  
Therapeutic Response ◽  
Vertebral Osteomyelitis ◽  
Oral Antibiotics ◽  
Normal Range ◽  
Vas Score ◽  
Pyogenic Vertebral Osteomyelitis ◽  
Culture Positive ◽  
Culture Negative

Abstract Background There are still controversies over the treatment and outcomes in culture-negative pyogenic vertebral osteomyelitis (PVO). The purpose of this study is to investigate the antimicrobial therapy, assessment of therapeutic response, and outcome of culture-negative PVO compared to culture-positive PVO. Methods Retrospective study was performed with non-surgical lumbar PVO. The patients were divided into two groups based on the causative bacterial identification (CN group with culture-negative and CP group with culture-positive). The clinical features, use of antibiotics, laboratory data, and outcomes were compared between the two groups. Results Seventy-three patients with 41 (56.2%) of the CN group and 32 (43.8%) of the CP group were enrolled. Group CN showed a shorter duration of parenteral antibiotics (45.88 ± 16.14 vs. 57.31 ± 24.39, p = 0.019) although a tendency of prolonged duration of total (parenteral + oral) antibiotics (101.17 ± 52.84 vs. 84.19 ± 50.29 days, p = 0.168). When parenteral antibiotics were discontinued or switched to oral antibiotics, erythrocyte segmentation rate (ESR, normal range: < 20 mm/h), C-reactive protein (CRP, normal range: < 0.5 mg/dL), and visual analogue scale (VAS) score for back pain were 42.86 ± 24.05 mm/h, 0.91 ± 1.18 mg/dL, and 4.05 ± 1.07, respectively, with no significant differences between the two groups. The recurrence rates of CN and CP groups were 7.3% (3/41) and 6.3% (2/32), respectively (p = 1.000). Conclusions CN group required a shorter duration of parenteral antibiotics than CP group. Discontinuation of parenteral antibiotics or changing administration route can be considered based on the values of ESR, CRP, and VAS score for back pain.

scholarly journals Executive Summary: 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adultsa

2015 ◽  
Vol 61 (6) ◽  
pp. 859-863 ◽  
Author(s):  
Elie F. Berbari ◽  
Souha S. Kanj ◽  
Todd J. Kowalski ◽  
Rabih O. Darouiche ◽  
Andreas F. Widmer ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Clinical Practice ◽  
Practice Guidelines ◽  
Antimicrobial Therapy ◽  
Healthcare Professionals ◽  
Surgical Intervention ◽  
Vertebral Osteomyelitis ◽  
Executive Summary ◽  
Orthopedic Surgeons ◽  
Infectious Disease Specialists

Abstract These guidelines are intended for use by infectious disease specialists, orthopedic surgeons, neurosurgeons, radiologists, and other healthcare professionals who care for patients with native vertebral osteomyelitis (NVO). They include evidence and opinion-based recommendations for the diagnosis and management of patients with NVO treated with antimicrobial therapy, with or without surgical intervention.

P108. Anterior Allograft Bone Dowel Treatment of Pyogenic Vertebral Osteomyelitis

2006 ◽  
Vol 6 (5) ◽  
pp. 135S-136S
Author(s):  
Michael Dabbah ◽  
Justin Tortolani ◽  
Ira L. Fedder ◽  
Farhan Siddiqi ◽  
Victor Hayes ◽  
...  
Keyword(s):  
Vertebral Osteomyelitis ◽  
Allograft Bone ◽  
Pyogenic Vertebral Osteomyelitis

scholarly journals Epidemiology, Microbiological Diagnosis, and Clinical Outcomes in Pyogenic Vertebral Osteomyelitis: A 10-year Retrospective Cohort Study

2018 ◽  
Vol 5 (3) ◽  
Author(s):  
Brian S W Chong ◽  
Christopher J Brereton ◽  
Alexander Gordon ◽  
Joshua S Davis
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Vertebral Osteomyelitis ◽  
Index Admission ◽  
Causative Organism ◽  
Microbiological Diagnosis ◽  
Treatment Pathways ◽  
Pyogenic Vertebral Osteomyelitis

Abstract Background Pyogenic vertebral osteomyelitis (PVO) is rising in incidence, but optimal methods of investigation and duration of antibiotic therapy remain controversial. Methods We conducted a single-center retrospective cohort study of PVO at an Australian teaching hospital. We included all adults with a first episode of PVO between 2006 and 2015. PVO was defined based on the presence of prespecified clinical and radiological criteria. The main exposures of interest were investigation strategy and antibiotic treatment. The main outcome measures were duration of hospital admission, mortality during index admission, symptom resolution during index admission, and attributable readmission within 2 years. Results Of 129 included patients, 101 (78%) had a causative organism identified. Patients with an identified pathogen were more likely to be febrile (75% compared with 29%, P &lt; .001) and had a higher mean admission C-reactive protein (207 vs 54, P &lt; .001) compared with patients without an identified pathogen. However, they were less likely to experience an adverse outcome (death or attributable readmission within 2 years; adjusted odds ratio, 0.36; 95% confidence interval, 0.13–0.99; P = .04). Open biopsy of vertebral tissue had a higher diagnostic yield (70%) than fine needle aspirate (41%) or core biopsy (30%). Despite receiving a median of 6 weeks of intravenous antibiotics, only 15% of patients had a full recovery on discharge from index admission. Conclusions Clinical outcomes for patients with PVO were poor. Obtaining a microbiological diagnosis is associated with a better outcome. However, prospective and randomized studies are essential to establishing optimal investigation and treatment pathways.

scholarly journals 699Long Term Outcome of Pyogenic Vertebral Osteomyelitis: A Cohort Study of 260 Patients

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S198-S198
Author(s):  
Arjun Gupta ◽  
Todd Kowalski ◽  
Douglas Osmon ◽  
Mark Enzler ◽  
James Steckelberg ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vertebral Osteomyelitis ◽  
Term Outcome ◽  
Pyogenic Vertebral Osteomyelitis

scholarly journals Treatment of Thoracolumbar Spinal Infections through Anterolateral Approaches Using Expandable Titanium Mesh Cage for Spine Reconstruction

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Tarantino Roberto ◽  
Marruzzo Daniele ◽  
Cappelletti Martina ◽  
De Giacomo Tiziano ◽  
Delfini Roberto
Keyword(s):  
Vertebral Osteomyelitis ◽  
Diagnostic Tools ◽  
Anterolateral Approach ◽  
Titanium Mesh ◽  
Titanium Mesh Cage ◽  
Vital Functions ◽  
Mesh Cage ◽  
Pyogenic Vertebral Osteomyelitis ◽  
University Of Rome ◽  
Spinal Infections

Pyogenic vertebral osteomyelitis (PVO) is still a rare pathology. However, its incidence is on the rise. This is due to an increasing population with predisposing factors. Also, the availability of more effective diagnostic tools has brought it increasingly to the surgeon’s attention. In this study the patients were treated in the Neurosurgery Division of the Department of Neurological Sciences and Psychiatry of the Sapienza University of Rome, between 2001 and 2009. They had thoracolumbar pyogenic spondylitis. This study was undertaken in order to identify the correct diagnostic and therapeutic treatment needed in such cases. From the cases studied here, it is evident that spinal infections can be extremely insidious and that diagnosis tends to be reached late. Surgery, along with the antibiotic treatment, allows for eradication of the causes of the pathology by the reclamation of the affected region. Surgery is also fundamental in helping to recover vital functions and in restoring as much as possible the correct curvature of the rachises. The use of an anterolateral approach is dictated by the necessity of obtaining 360° stability as well as by the need to clear away extensive infections, which are not always reachable using a posterior approach.

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