Spondylodiscitis in the elderly patient: clinical mid-term results and quality of life.
BACKGROUND
Focusing on spondylodiscitis in elderly patients current literature does not contain much information.


METHODS
We performed a retrospective case series (n = 32) comparing conservative (group 1; n = 16) versus operative (group 2; n = 16) treated spondylodiscitis patients aged > or =65 years (mean age 74.9 years) from January 2002 to April 2004. The review of the medical records provided information about the pre-hospital time, the inpatient course and the time after discharge. At follow-up (FU) (mean 3.6 years) disease specific and general quality of life (QOL) questionnaires (COMI back patient self-assessment, ODI and SF-36) were administered.


RESULTS
Altogether, 71.9% of the patients could be contacted; 12.5% had died since hospitalisation and 15.6% could not be contacted anymore. At FU based on the visual analogue scale, patients indicated an average of 3.2 for back pain and 2.5 for leg pain. ODI scoring yielded minimal disability for 38.9%, a moderate disability for 22.2%, a severe disability for 22.2% and for 11.1% a crippled situation; 5.6% were bed-ridden or exaggerated their symptoms. The SF-36 PCS amounted to an average of 38.2, the MCS 50.6. Owing to additional surgery-associated risks, operative treatment of spondylodiscitis feature a complication rate twice as high in the respective group, but general complications do not differ. At FU, no statistically remarkable difference concerning QOL and remaining pain became evident between the groups, the operated patients being more satisfied with regard to the treatment of spondylodiscitis.


CONCLUSIONS
Ultimately, if surgery is indicated the operative risks should be borne in mind, but advanced age should not be the crucial factor in decision-making.
Sobottke
Rolf
R
Department of Orthopaedic and Trauma Surgery, University of Cologne, Joseph-Stelzmann-Strasse 9, Cologne, Germany. rolf.sobottke@uk-koeln.de
Röllinghoff
Marc
M
Zarghooni
Keta
K
Zarghooni
Kourosh
K
Schlüter-Brust
Klaus
K
Delank
Karl-Stefan
KS
Seifert
Harald
H
Zweig
Thomas
T
Eysel
Peer
P
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015299:Discitis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010147:Pain Measurement; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000379:methods; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000700:Analgesics; D000900:Anti-Bacterial Agents