title: Postoperative spondylodiskitis: etiology, clinical findings, prognosis, and comparison with nonoperative pyogenic spondylodiskitis.
abstract: We studied 31 cases of postoperative pyogenic spondylodiskitis (POS), comparing them with 72 cases of nonpostoperative pyogenic spondylodiskitis (NPOS). POS represents 30.1% of cases of pyogenic spondylodiskitis. The onset of symptoms occurred an average (+/-SD) of 27.7 (+/- 25.3) days following surgery. Predisposing factors were less frequent in POS than NPOS cases (P = .002). Neurological complications and inflammatory signs in the spine were more frequent with POS than with NPOS (P = .002 and P < .00001). Coagulase-negative Staphylococcus and anaerobic bacteria were more frequent in POS than in NPOS (P = .0001 and P = .05). Percutaneous bone biopsies yielded the etiology in 66.7% of cases, open bone biopsies in 100%, blood cultures in 55.6%, and cultures of adjacent foci in 94.4%. Eleven patients (35.5%) were cured with antimicrobial treatment, but surgical treatment was necessary in 64.5%. No relapses or deaths were recorded. Seventeen patients (54.8%) had severe functional sequelae, which were associated with inflammatory signs in the spine (P = .033), higher levels of leukocytosis (P = .05), higher erythrocyte sedimentation rates (P = .05), and paravertebral abscesses (P = .04).
authors.affiliation: Service of Infectious Diseases, University Hospital Virgen del Rocio, Seville, Spain. jpachon@hvr.sas.cica.es
authors.forename: M E
authors.initials: ME
authors.lastname: Jiménez-Mejías
authors.forename: J
authors.initials: J
authors.lastname: de Dios Colmenero
authors.forename: F J
authors.initials: FJ
authors.lastname: Sánchez-Lora
authors.forename: J
authors.initials: J
authors.lastname: Palomino-Nicás
authors.forename: J M
authors.initials: JM
authors.lastname: Reguera
authors.forename: J
authors.initials: J
authors.lastname: García de la Heras
authors.forename: M A
authors.initials: MA
authors.lastname: García-Ordoñez
authors.forename: J
authors.initials: J
authors.lastname: Pachón
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015299:Discitis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013131:Spine / Q000601:surgery*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology