An Analysis of Patients with Single and Combined Pyogenic Spinal Infections / 대한정형외과학회잡지

PURPOSE: Pyogenic spinal infection encompasses a broad range of clinical entities, treatment and prognosis. We compared the symptoms and treatment efficacy of patients with single and combined spinal infections. MATERIALS AND METHODS: Between June 2001 and November 2006, 30 patients with pyogenic spinal infections were treated in our hospital and outcomes were evaluated through ESR, CRP, and clinical improvement. Groups 1 and 2 represented patients with single lesions and patients with combined lesions, respectively. RESULTS: Group 1 included 7 men and 8 women, and the preoperative mean ESR and CRP were 62.7 mm/hr and 5.7 mg/dl. The most common clinical presentation was back pain. Nine patients in group 1 underwent operation, and two underwent instrumentation. Group 2 included 4 men and 11 women, and the preoperative mean ESR and CRP were 78.5 mm/hr and 16.7 mg/dl. The most common clinical presentations were back pain and fever. Thirteen patients in group 2 underwent operation, and six underwent instrumentation. There were more underlying diseases in group 2. CONCLUSION: There were more underlying diseases and higher preoperative inflammatory-reactive laboratory findings in patients with combined spinal infections. Careful attention must be directed to treatment in order to secure favorable clinical outcomes in patients with combined infections.

Prognostic Factors of Pyogenic Spinal Infections

OBJECTIVE: This study is performed to evaluate the clinical manifestations and prognostic factors among patients with pyogenic spinal infections. METHODS: The records and radiologic data of 27 patients treated between 2001 and 2003 were retrospectively evaluated. RESULTS: All patients (mean age, 55.2yrs) were treated with i.v. antibiotics and 13(48.1%) required surgical treatment. Mean follow up duration was 38.9 weeks. The sixteen patients(59.2%) had previous surgical procedure on spine and six patients(22.0%) had local injections. The ten patients had predisposing factor (such as, diabetes mellitus, UTI, liver cirrhosis, septic condition). The most common symptoms are lower back pain and motor weakness. Causative organisms determined only in ten patients(37%) and Staphylococcus aureus(50%) was most common. C-reactive protein(CRP) and white blood cell(WBC) count were more correlated with clinical outcome than erythrocyte sedimentation rate(ESR). CONCLUSION: CRP and WBC level can be significant parameters of treatment and prognosis in pyogenic spinal infection.