Treatment algorithm for spontaneous spinal infections: A review of the literature.

Authors:
Giovanni Grasso
Giovanni Grasso
University of Messina
Italy
Giancarlo Iaiani
Giancarlo Iaiani
Sapienza Università di Roma
Italy
Nicola Marotta
Nicola Marotta
University of Rome Sapienza
Italy
Fabio Torregrossa
Fabio Torregrossa
University of Palermo
Palermo | Italy
Alessandro Landi
Alessandro Landi
University of Rome Sapienza

J Craniovertebr Junction Spine 2019 Jan-Mar;10(1):3-9

Department of Human Neurosciences, Division of Neurosurgery, Sapienza University of Rome, Rome, Italy.

Background: Primary spinal infections are rare pathologies with an estimated incidence of 5% of all osteomyelitis. The diagnosis can be challenging and this might result in a late identification. The etiological diagnosis is the primary concern to determine the most appropriate treatment. The aim of this review article was to identify the importance of a methodological attitude toward accurate and prompt diagnosis using an algorithm to aid on spinal infection management.

Methods: A search was done on spinal infection in some databases including PubMed, ISI Web of Knowledge, Google Scholar, Ebsco, Embasco, and Scopus.

Results: Literature reveals that on the basis of a clinical suspicion, the diagnosis can be formulated with a rational use of physical, radiological, and microbiological examinations. Microbiological culture samples can be obtained by a percutaneous computed tomography-guided procedure or by an open surgical biopsy. When possible, the samples should be harvested before antibiotic treatment is started. Indications for surgical treatment include neurological deficits or sepsis, spine instability and/or deformity, presence of epidural abscess and failure of conservative treatment.

Conclusion: A multidisciplinary approach involving both a spinal surgeon and an infectious disease specialist is necessary to better define the treatment strategy. Based on literature findings, a treatment algorithm for the diagnosis and management of primary spinal infections is proposed.

Download full-text PDF

Source
http://dx.doi.org/10.4103/jcvjs.JCVJS_115_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469318PMC
April 2019
2 Reads

Publication Analysis

Top Keywords

spinal infections
12
spinal infection
8
treatment algorithm
8
primary spinal
8
spinal
6
treatment
6
diagnosis
5
samples percutaneous
4
percutaneous computed
4
microbiological culture
4
microbiological examinations
4
examinations microbiological
4
computed tomography-guided
4
culture samples
4
procedure open
4
harvested antibiotic
4
antibiotic treatment
4
treatment started
4
samples harvested
4
biopsy samples
4

Similar Publications