K Papavasiliou, S Panagiotidou, P Kakoulidis, P Domashenko, E Kenanidis, Α Bintoudi, K Arvaniti, M Potoupnis, I Sarris, E Tsiridis
{"title":"对于自发性非特异性化脓性脊柱盘炎患者来说，保守治疗仍不失为一种可行的治疗方案。对 47 名患者进行的回顾性审计研究。","authors":"K Papavasiliou, S Panagiotidou, P Kakoulidis, P Domashenko, E Kenanidis, Α Bintoudi, K Arvaniti, M Potoupnis, I Sarris, E Tsiridis","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Spontaneous non-specific pyogenic spondylodiscitis (SNPS) is a rare medical condition, whose optimal treatment remains controversial. We evaluated the multidisciplinary protocol implemented at our department for the conservative treatment of patients with SNPS.</p><p><strong>Methods: </strong>Patients with lumbar or thoracic SNPS, whose treatment was initiated conservatively and had at least six months of follow-up, were enrolled in this retrospective audit study. Patients with specific, postoperative, or iatrogenic spondylodiscitis or necessitating immediate operative treatment were excluded. The location of the infection, initial symptoms, co-morbidities, pathogens, duration of antibiotic treatment, hospitalization and follow-up, and outcome were retrieved. The visual analogue scale (VAS) score was used to register pain improvement after treatment.</p><p><strong>Results: </strong>Between January 2011 and December 2021, forty-seven patients (male: 26, mean age: 68.5 years) with SNPS (lumbar: 29, thoracic: 18) were hospitalized. The main co-morbidity was diabetes mellitus (23 patients). Pain was the predominant (46 patients), and fever was the second most common (19 patients) symptom. The most frequent causative microorganism was staphylococcus aureus (29 patients); no pathogen was identified in ten patients. The mean hospitalization duration for patients completing their conservative treatment (43/47) was 27 (range: 22-41) days. They received antibiotics for a mean period of 23 days intravenously (range: 21-29), 23.8 days <i>per os</i> (range: 21-35), and 46.8 days in total (range: 42-63). Conservative treatment was discontinued in two females. Two male patients died due to septic shock. The mean follow-up was 11.5 months (range: 6-15). During follow-up, no one developed any neurologic deficit and/or recurrence. There was a significant improvement in the mean VAS, from 8.3 ± 0.8 pre-treatment to 1.6 ± 0.5 at the latest follow-up (p <0.001).</p><p><strong>Conclusions: </strong>Although treatment is gradually shifting towards surgical intervention, conservative therapeutic management of SNPS patients with antibiotic administration, bed rest, and careful mobilization remains a viable and efficacious option. HIPPOKRATIA 2023, 27 (2):106-111.</p>","PeriodicalId":50405,"journal":{"name":"Hippokratia","volume":"27 3","pages":"106-111"},"PeriodicalIF":0.3000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305160/pdf/","citationCount":"0","resultStr":"{\"title\":\"Conservative treatment may be still considered a viable therapeutic option for patients with spontaneous non-specific pyogenic spondylodiscitis. A retrospective audit study of 47 patients.\",\"authors\":\"K Papavasiliou, S Panagiotidou, P Kakoulidis, P Domashenko, E Kenanidis, Α Bintoudi, K Arvaniti, M Potoupnis, I Sarris, E Tsiridis\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Spontaneous non-specific pyogenic spondylodiscitis (SNPS) is a rare medical condition, whose optimal treatment remains controversial. We evaluated the multidisciplinary protocol implemented at our department for the conservative treatment of patients with SNPS.</p><p><strong>Methods: </strong>Patients with lumbar or thoracic SNPS, whose treatment was initiated conservatively and had at least six months of follow-up, were enrolled in this retrospective audit study. Patients with specific, postoperative, or iatrogenic spondylodiscitis or necessitating immediate operative treatment were excluded. The location of the infection, initial symptoms, co-morbidities, pathogens, duration of antibiotic treatment, hospitalization and follow-up, and outcome were retrieved. The visual analogue scale (VAS) score was used to register pain improvement after treatment.</p><p><strong>Results: </strong>Between January 2011 and December 2021, forty-seven patients (male: 26, mean age: 68.5 years) with SNPS (lumbar: 29, thoracic: 18) were hospitalized. The main co-morbidity was diabetes mellitus (23 patients). Pain was the predominant (46 patients), and fever was the second most common (19 patients) symptom. The most frequent causative microorganism was staphylococcus aureus (29 patients); no pathogen was identified in ten patients. The mean hospitalization duration for patients completing their conservative treatment (43/47) was 27 (range: 22-41) days. They received antibiotics for a mean period of 23 days intravenously (range: 21-29), 23.8 days <i>per os</i> (range: 21-35), and 46.8 days in total (range: 42-63). Conservative treatment was discontinued in two females. Two male patients died due to septic shock. The mean follow-up was 11.5 months (range: 6-15). During follow-up, no one developed any neurologic deficit and/or recurrence. There was a significant improvement in the mean VAS, from 8.3 ± 0.8 pre-treatment to 1.6 ± 0.5 at the latest follow-up (p <0.001).</p><p><strong>Conclusions: </strong>Although treatment is gradually shifting towards surgical intervention, conservative therapeutic management of SNPS patients with antibiotic administration, bed rest, and careful mobilization remains a viable and efficacious option. HIPPOKRATIA 2023, 27 (2):106-111.</p>\",\"PeriodicalId\":50405,\"journal\":{\"name\":\"Hippokratia\",\"volume\":\"27 3\",\"pages\":\"106-111\"},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305160/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hippokratia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hippokratia","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Conservative treatment may be still considered a viable therapeutic option for patients with spontaneous non-specific pyogenic spondylodiscitis. A retrospective audit study of 47 patients.
Background: Spontaneous non-specific pyogenic spondylodiscitis (SNPS) is a rare medical condition, whose optimal treatment remains controversial. We evaluated the multidisciplinary protocol implemented at our department for the conservative treatment of patients with SNPS.
Methods: Patients with lumbar or thoracic SNPS, whose treatment was initiated conservatively and had at least six months of follow-up, were enrolled in this retrospective audit study. Patients with specific, postoperative, or iatrogenic spondylodiscitis or necessitating immediate operative treatment were excluded. The location of the infection, initial symptoms, co-morbidities, pathogens, duration of antibiotic treatment, hospitalization and follow-up, and outcome were retrieved. The visual analogue scale (VAS) score was used to register pain improvement after treatment.
Results: Between January 2011 and December 2021, forty-seven patients (male: 26, mean age: 68.5 years) with SNPS (lumbar: 29, thoracic: 18) were hospitalized. The main co-morbidity was diabetes mellitus (23 patients). Pain was the predominant (46 patients), and fever was the second most common (19 patients) symptom. The most frequent causative microorganism was staphylococcus aureus (29 patients); no pathogen was identified in ten patients. The mean hospitalization duration for patients completing their conservative treatment (43/47) was 27 (range: 22-41) days. They received antibiotics for a mean period of 23 days intravenously (range: 21-29), 23.8 days per os (range: 21-35), and 46.8 days in total (range: 42-63). Conservative treatment was discontinued in two females. Two male patients died due to septic shock. The mean follow-up was 11.5 months (range: 6-15). During follow-up, no one developed any neurologic deficit and/or recurrence. There was a significant improvement in the mean VAS, from 8.3 ± 0.8 pre-treatment to 1.6 ± 0.5 at the latest follow-up (p <0.001).
Conclusions: Although treatment is gradually shifting towards surgical intervention, conservative therapeutic management of SNPS patients with antibiotic administration, bed rest, and careful mobilization remains a viable and efficacious option. HIPPOKRATIA 2023, 27 (2):106-111.
期刊介绍：
Hippokratia journal is a quarterly issued, open access, peer reviewed, general medical journal, published in Thessaloniki, Greece. It is a forum for all medical specialties. The journal is published continuously since 1997, its official language is English and all submitted manuscripts undergo peer review by two independent reviewers, assigned by the Editor (double blinded review process).
Hippokratia journal is managed by its Editorial Board and has an International Advisory Committee and over 500 expert Reviewers covering all medical specialties and additionally Technical Reviewers, Statisticians, Image processing Experts and a journal Secretary. The Society “Friends of Hippokratia Journal” has the financial management of both the printed and electronic edition of the journal.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
