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The Kurume Medical Journal Sep 2019Although pyogenic spondylitis is an infrequent infection, its incidence is increasing because of the growing number of elderly people and immunocompromised patients.... (Review)
Review
Although pyogenic spondylitis is an infrequent infection, its incidence is increasing because of the growing number of elderly people and immunocompromised patients. Diagnosis is often difficult and appropriate imaging, blood cultures and/or biopsy are essential in making an early diagnosis. Most of the cases can be treated non-operatively. Surgical treatment is indicated in patients with spinal cord or cauda equine compression with progressive neurological deficits and/or patients who have failed conservative treatment. Early and accurate diagnosis of pyogenic spondylitis is important for timely and effective management, in order to reduce the occurrence of spinal deformity and dysfunction.
Topics: Humans; Magnetic Resonance Imaging; Spondylitis
PubMed: 31406038
DOI: 10.2739/kurumemedj.MS653001 -
International Orthopaedics Feb 2012Pyogenic spondylitis is a neurological and life threatening condition. It encompasses a broad range of clinical entities, including pyogenic spondylodiscitis, septic... (Review)
Review
Pyogenic spondylitis is a neurological and life threatening condition. It encompasses a broad range of clinical entities, including pyogenic spondylodiscitis, septic discitis, vertebral osteomyelitis, and epidural abscess. The incidence though low appears to be on the rise. The diagnosis is based on clinical, radiological, blood and tissue cultures and histopathological findings. Most of the cases can be treated non-operatively. Surgical treatment is required in 10-20% of patients. Anterior decompression, debridement and fusion are generally recommended and instrumentation is acceptable after good surgical debridement with postoperative antibiotic cover.
Topics: Blood Sedimentation; C-Reactive Protein; Debridement; Fluorodeoxyglucose F18; Humans; Incidence; Magnetic Resonance Imaging; Positron-Emission Tomography; Radiopharmaceuticals; Plastic Surgery Procedures; Spondylitis
PubMed: 22033610
DOI: 10.1007/s00264-011-1384-6 -
BMC Musculoskeletal Disorders Aug 2020Spinal fungal infections, especially spinal Aspergillus infections, are rare in the clinic. Here, we introduce the clinical features, diagnosis, treatment, and prognoses... (Review)
Review
BACKGROUND
Spinal fungal infections, especially spinal Aspergillus infections, are rare in the clinic. Here, we introduce the clinical features, diagnosis, treatment, and prognoses of 6 cases of Aspergillus spondylitis.
METHODS
We retrospectively analysed the complete clinical data of patients with Aspergillus spondylitis treated in our hospital from January 2013 to January 2020.
RESULTS
Aspergillus fumigatus was isolated in 4 cases, and Aspergillus spp. and Aspergillus niger were isolated in 1 case each. All six patients reported varying degrees of focal spinal pain; one patient reported radiating pain, one patient experienced bowel dysfunction and numbness in both lower limbs, and three patients had fever symptoms. One case involved the thoracic spine, one case involved the thoracolumbar junction, and 4 cases involved the lumbar spine. Three patients were already in an immunosuppressed state, and three patients entered an immunosuppressed state after spinal surgery. All six patients were successfully cured, and five required surgery. Of the 5 patients who underwent surgical treatment, 2 had spinal cord compression symptoms, and 3 had spinal instability. At the end of follow-up, 1 patient reported left back pain and 1 patient reported left limb numbness.
CONCLUSION
The clinical manifestations of Aspergillus spondylitis are non-specific, and the diagnosis depends on typical imaging findings and microbiological and histopathological examination results. When there is no spinal instability, spinal nerve compression symptoms, or progressive deterioration, antifungal therapy alone may be considered. If spinal instability, spinal nerve compression, or epidural abscess formation is present, surgery combined with antifungal therapy is recommended.
Topics: Aspergillus; Epidural Abscess; Humans; Retrospective Studies; Spinal Cord Compression; Spondylitis
PubMed: 32828133
DOI: 10.1186/s12891-020-03582-x -
Der Radiologe Jun 2006Spondylitis is an inflammation of the vertebral body. If the infection is manifested in the vertebral motor segment it is called spondylodiscitis, which can be divided... (Review)
Review
Spondylitis is an inflammation of the vertebral body. If the infection is manifested in the vertebral motor segment it is called spondylodiscitis, which can be divided into specific and nonspecific forms. It is clinically impressive that at the beginning of the disease, the patients who are quite often immunosuppressed suffer from localized, especially nocturnally exacerbated backache. The initial diagnostic work-up generally consists of clinical history, examination, laboratory tests, and (especially advanced) imaging findings. Although computed tomography still remains the most frequently used advanced imaging technique, magnetic resonance imaging is the golden standard for the diagnosis of spondylitis and spondylodiscitis.
Topics: Back Pain; Discitis; Humans; Magnetic Resonance Imaging; Practice Guidelines as Topic; Practice Patterns, Physicians'; Spondylitis; Tomography, X-Ray Computed
PubMed: 16609839
DOI: 10.1007/s00117-006-1368-5 -
Journal of Clinical Rheumatology :... Jan 2022With the advent of classification criteria for psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), patients with axial manifestations associated with... (Review)
Review
With the advent of classification criteria for psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), patients with axial manifestations associated with psoriasis, initially described in the l950s as a specific entity termed psoriatic spondylitis (PS), are now categorized within PsA, ankylosing spondylitis (AS), and axSpA. Thus, different terms are used to describe axial disease in patients with PsA including PS, axial psoriatic arthritis (axPsA), and psoriatic spondyloarthritis. Patients with PS may present with inflammatory and/or mechanical back pain, but also may display axial disease on imaging despite not complaining of back pain. Cervical spondylitis has been reported in 35% to 75% of patients with PsA. Axial disease is silent in 20% and 25% of patients with axial PsA and PsA, respectively. The majority of axPsA patients have peripheral arthritis alongside the axial involvement, whereas only 2% to 5% of PsA patients have solely axial arthritis with no peripheral arthritis.A debate is currently underway as to whether inflammatory axial disease and psoriasis represent axSpA with psoriasis or a subset of PsA named axPsA. Studies have recognized that axial disease in PsA patients seems to be different demographically, genetically, clinically, and radiographically when compared with AS with or without psoriasis. This narrative review summarizes current knowledge regarding axial involvement of PsA in terms of history, terminology, classification, epidemiology, clinical presentation, imaging, diagnosis, and treatment, with the aim of providing advice for management of PS in clinical evidence-based practice. Data-driven studies are needed to develop clear, nonoverlapping classification criteria for spinal involvement in PsA.
Topics: Arthritis, Psoriatic; Axial Spondyloarthritis; Humans; Rheumatologists; Spondylarthritis; Spondylitis, Ankylosing
PubMed: 34941618
DOI: 10.1097/RHU.0000000000001815 -
Zeitschrift Fur Rheumatologie Feb 2006Infectious spondylitis usually involves osteomyelitis in two adjacent vertebral bodies and the intervertebral disc (spondylodiscitis). The most common location is the... (Review)
Review
Infectious spondylitis usually involves osteomyelitis in two adjacent vertebral bodies and the intervertebral disc (spondylodiscitis). The most common location is the lumbar spine, followed by the thoracic spine. Symptoms are nonspecific, leading to a delay in diagnosis, in many cases, of several weeks. A large number of infectious agents can cause vertebral osteomyelitis, usually reaching the vertebra by hematogenous spread. The most commonly isolated agent is Staphylococcus aureus. Spondylitis remains the most common skeletal manifestation of tuberculosis. As with other forms of osteomyelitis, microbiological diagnosis is essential for the choice of adequate therapy. The majority of cases can be cured with antibiotic therapy alone.
Topics: Anti-Bacterial Agents; Bacterial Infections; Diagnosis, Differential; Humans; Osteomyelitis; Practice Guidelines as Topic; Practice Patterns, Physicians'; Spondylitis
PubMed: 16421642
DOI: 10.1007/s00393-005-0017-0 -
Seminars in Ultrasound, CT, and MR Dec 2004Infection of the spine is a rare but serious cause of back pain. Conventional radiographs remain the initial screening procedure. Typically two adjacent vertebral bodies... (Review)
Review
Infection of the spine is a rare but serious cause of back pain. Conventional radiographs remain the initial screening procedure. Typically two adjacent vertebral bodies and the intervening disk space are affected. Early in the course of the disease, radiographs may be normal or nondiagnostic. Magnetic resonance imaging or radionuclide bone scan will establish pathology centered in the vertebral body. Because of the ability to image soft tissues, magnetic resonance imaging is particularly helpful in detecting paravertebral and extradural abscesses. Four other conditions may mimic infectious spondylitis: degenerative disk disease associated with Modic type 1 changes, pseudoarthrosis in ankylosing spondylitis, dialysis spondyloarthropathy, and neuropathic spondyloarthropathy. Advanced imaging studies in combination with radiographs and clinical information are essential in determining the correct diagnosis.
Topics: Bacterial Infections; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Spinal Diseases; Spondylitis; Tomography, X-Ray Computed; Tuberculosis, Spinal
PubMed: 15663317
DOI: 10.1053/j.sult.2004.09.003 -
Praxis Aug 2020Tuberculous Spondylitis - Diagnosis and Management Despite a decreasing incidence of tuberculosis (TB) over the last decades in Switzerland, the frequency of newly...
Tuberculous Spondylitis - Diagnosis and Management Despite a decreasing incidence of tuberculosis (TB) over the last decades in Switzerland, the frequency of newly diagnosed tuberculous spondylitis has remained stable. It occurs most frequently in old, immunocompromised persons and/or persons who have moved to Switzerland from TB endemic areas. It is a chronic manifestation of TB, which is characterized by 'cold abscesses', neurological deficits and kyphotic spinal deformity. Tuberculous spondylitis is often diagnosed with a delay, which can lead to higher morbidity and treatment complexity. Antibiotic therapy is essential in tuberculous spondylitis. Surgical interventions aim to obtain samples, decompress nervous structures, obtain pain control and, if necessary, deformity correction/stabilization. This paper provides an overview of the modern diagnostic and therapeutic management of tuberculous spondylitis in Switzerland.
Topics: Humans; Spondylitis; Switzerland; Tuberculosis, Spinal
PubMed: 32752962
DOI: 10.1024/1661-8157/a003518 -
BMC Surgery Aug 2020Spondylitis is a very common back problem in orthopedics, but is rarely caused by Salmonella enteritidis. We herein reported an uncommon case of thoracic spondylitis... (Review)
Review
BACKGROUND
Spondylitis is a very common back problem in orthopedics, but is rarely caused by Salmonella enteritidis. We herein reported an uncommon case of thoracic spondylitis caused by Salmonella enteritidis.
CASE PRESENTATION
A 68-year-old man with high fever was diagnosed as salmonella septicemia initially. His condition was improved after antibacterial treatment. But the symptom of pyrexia was recurred after some days. He was then diagnosed with thoracic spondylitis caused by salmonella enteritidis. After that, he was put on strict antibiotic treatment, and underwent intervertebral lesion debridement, partial rib resection, intervertebral bone fusion and pedicle screw internal fixation. Subsequently, the patient had a significant relief in pain, temperature remained normal, and had no severe complications.
CONCLUSIONS
Special attention should be paid to systemic pain and remain cautious to the occurrence of osteomyelitis in patients with Salmonella septicemia. Moreover, the treatment time for using sensitive antibiotics should be sufficient. Surgical treatment should be considered if strict conservative treatment is failed.
Topics: Aged; Female; Humans; Lumbar Vertebrae; Male; Salmonella Infections; Salmonella enteritidis; Spondylitis; Thoracic Vertebrae
PubMed: 32767972
DOI: 10.1186/s12893-020-00841-5 -
Arthritis and Rheumatism Dec 1961
Topics: Arthritis; Arthritis, Rheumatoid; Humans; Spondylitis; Spondylitis, Ankylosing
PubMed: 13901041
DOI: 10.1002/art.1780040612