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Pan Arab Journal of Neurosurgery. 2010; 14 (1): 38-45
em Inglês | IMEMR | ID: emr-98303

RESUMO

This review of spinal infections was conducted to better define the population at risk, the affected levels, presentation, causative organisms, duration of antibiotic treatment and indications for surgery. A retrospective analysis of 70 consecutive patients with primary spinal infection [epidural abscess and/or vertebral osteomyelitis] that presented between January 2001 and August 2004 was performed. These patients had not undergone immediate prior spinal surgery. We analyzed patient demographics, co-morbidities, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP] and white blood cell count [WBC], management and outcomes. The mean age at presentation was 56.4 years [range 8 to 85], with 69% over the age of 50. Over half [56%] were male and 44% were female. Over a quarter [27%] presented with vertebral osteomyelitis, 40% with spinal epidural abscess, and 33% with both. Pain was the most common symptom, occurring in 77% at presentation. Co-morbid diseases included hypertension [41%], diabetes [33%], heart disease [27%] and pulmonary disease [20%]. Forty-one percent were treated with antibiotics alone while 59% underwent a surgical procedure. Ten percent failed initial medical management and required surgery. Time from diagnosis to surgery ranged from 3 to 10 weeks. Surgery was undertaken for decompression or stabilization. All but one patient improved at last follow-up. Declines in ESR and CRP correlated strongly with treatment success while WBC had less correlation. Parenteral antibiotic therapy averaged 8 weeks. This retrospective study further defines the population at risk for spinal infection, outlines current strategies of medical and surgical management, demonstrates the usefulness of laboratory values and conveys outcomes


Assuntos
Humanos , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Doenças da Coluna Vertebral/tratamento farmacológico , Doenças da Coluna Vertebral/cirurgia , Estudos Retrospectivos , Abscesso Epidural , Espondilite/microbiologia , Doenças da Coluna Vertebral/diagnóstico , Medição de Risco
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