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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Management of spondylodiscitis: An evaluation of 44 patients

Behandlung von Spondylodiszitis: eine Untersuchung von 44 Patienten

Meeting Abstract

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  • corresponding author Thomas Kral - Neurochirurgische Universitätsklinik, Bonn
  • A. Jap - Neurochirurgische Universitätsklinik, Bonn
  • J. Schramm - Neurochirurgische Universitätsklinik, Bonn

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMI.04.11

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0280.shtml

Published: April 23, 2004

© 2004 Kral et al.
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Outline

Text

Objective

The aim of this retrospective clinical study was to analyze the pathologic entities and complications of spondylodiscitis (SD) and to compare duration and results of conservative and operative treatment in cases where surgery was offered to shorten the duration of hospitalization.

Methods

All clinical data were available in 44 of 52 patients with SD treated over a four year period. In this study group (14 female, 30 male) with a mean age of 60 ± 14 years 32% were younger than 60 years. SD was located in magnetic resonance imaging in the lumbar (N = 28), thoracic (N = 18) and cervical area (N = 8) and mostly monosegmental (64%) versus bisegmental (18%) or multisegmental (18%). The patients choose to have conservative treatment based on immobilization (bed rest, plaster shell) or operative treatment with dorsal stabilization and lateral fusion surgery. Antibiotic treatment was continued in both groups at least 10 weeks if C-reactive protein, white blood cell count and erythrocyte sedimentation rate were normal. Twenty-two patients were treated conservatively and surgically each.

Results

Unspecific back pain (93%) and fever (43%) were frequently seen symptoms at admission. Twenty-six patients had a history of infection and 20 of diabetes or neoplasia. Of 27 patients with neurological deficits 10 needed an emergency operation to evacuate intraspinal abscess. Causative organism were found in 69% with Staphylococcus aureus and coagulase negative Staphylococcus in most cases (50%). The group with conservative treatment had a significant longer mean hospital stay of 53 days versus 25 days after surgical stabilization/fusion. Wound infection and incorrect pedicle screw placement were followed by revision operations in 4 cases. Of 13 patients which had developed septic complications at admission or during their stay three died from septic shock. There was a complete recovery of neurological deficits in 9 patients and incomplete in 18 patients during the hospital stay.

Conclusions

Spondylodiscitis occurred not only in elderly patients and was often associated with a history of diabetes and neoplasia. The hospital stay was significantly shorter after surgical treatment.