Instability in Spinal Infection: Evaluating the Predictive Value of the Spinal Instability Spondylodiscitis Score...

Area of Science:

• Orthopedics
• Neurosurgery
• Infectious Diseases

Background:

• The Spinal Instability Spondylodiscitis Score (SISS) aids treatment decisions for spondylodiscitis.
• Its predictive value for radiologic and functional outcomes requires validation.

Purpose of the Study:

• Evaluate the SISS score's ability to predict radiologic progression in conservatively treated spondylodiscitis patients.
• Assess the association between SISS and functional outcomes in all treatment groups.

Main Methods:

• Retrospective observational cohort study of 176 pyogenic spondylodiscitis patients.
• SISS scores calculated from pretreatment MRI/CT; functional outcomes assessed using modified Rankin Scale (mRS).
• Analyses included predictive value, correlation, and multivariate regression.

Main Results:

• SISS classified patients as stable (14.77%), potentially unstable (44.89%), and unstable (40.34%).
• "SISS_unstable" showed moderate predictive value for deformity progression in conservatively treated patients (AUC=0.68).
• Vertebral destruction >50% predicted progression; SISS was not a significant predictor of functional outcomes (mRS 4-6).

Conclusions:

• The SISS score demonstrates fair predictive value for spinal deformity progression in spondylodiscitis.
• Instability alone does not correlate with functional outcomes, suggesting multifactorial influences.
• Future research should integrate broader patient factors for improved clinical decision-making.