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Pyogenic vertebral osteomyelitis: a review of 14 cases
1Department of Orthopaedic Surgery, National University Hospital, Singapore. dosnathe@nus.edu.sg
Journal of Orthopaedic Surgery (Hong Kong)
|December 21, 2005
Summary
Pyogenic vertebral osteomyelitis is common in elderly patients with diabetes. Effective management requires prompt diagnosis, often via computed tomography-guided biopsy, and aggressive treatment including surgery and prolonged antibiotics.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Neurosurgery
Background:
- Pyogenic vertebral osteomyelitis (PVO) is a serious spinal infection.
- Elderly individuals and those with comorbidities like diabetes are at higher risk.
- Timely and accurate diagnosis is crucial for effective management.
Purpose of the Study:
- To review and evaluate the management strategies for PVO.
- To analyze demographic patterns, predisposing factors, and clinical presentations of PVO patients.
- To assess treatment outcomes and complications in a cohort of PVO patients.
Main Methods:
- Retrospective review of 14 patients with PVO treated between 1998 and 2001.
- Analysis of demographic data, predisposing factors, clinical presentation, comorbidities, microbiology, and treatment approaches.
- Evaluation of surgical interventions, antibiotic therapy duration, and patient outcomes.
Main Results:
- The average patient age was 62.5 years, with a 6:1 male to female ratio.
- Diabetes mellitus was the most frequent predisposing condition (n=5).
- Staphylococcus aureus was the most common pathogen (n=9); surgical intervention was performed in 12 patients.
Conclusions:
- PVO is prevalent in the elderly, particularly those with diabetes.
- Computed tomography-guided needle biopsy is recommended for microbial identification.
- Aggressive surgical debridement and extended antibiotic therapy are vital for complex cases, including those with MRSA or P. pseudomallei.