title: Pyogenic spondylitis in the elderly: a report from Japan with the most aging society.
abstract: Pyogenic spondylitis can be life-threatening for elderly patients. To discuss the characteristics of the disease in the elderly, medical records of 103 consecutive cases of pyogenic spondylitis were reviewed. Of these, 45 cases were 65 years of age or older, and these 45 cases were enrolled into further study. In this study, the proportion of elderly patients among the total number with pyogenic spondylitis was 43.7%, and this figure has increased with the passing of time as follows: 37.5% (1988-1993), 44.4% (1994-1999), and 55.5% (2000-2005). The microorganisms were isolated in 16 cases: Staphylococcus aureus in 13 cases (including methicillin-resistant Staphylococcus aureus in nine) and others in three. Twenty-five patients had associated diseases: diabetes in 18 patients and malignant tumors in seven. Thirty patients were treated conservatively, and 15 patients underwent surgery. Twenty-six patients had paralysis. All 15 patients treated surgically, and eight of the 11 patients treated conservatively showed improvement in paralysis. Bone union was achieved in all cases except one. Our results indicate that a good outcome can be expected from conservative treatment in elderly patients as well as the young.
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, S1 W16, Sapporo, Hokkaido 060-8543, Japan. myoshimo@sapmed.ac.jp
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Yoshimoto
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takebayashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawaguchi
authors.forename: Hajime
authors.initials: H
authors.lastname: Tsuda
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ida
authors.forename: Takuro
authors.initials: T
authors.lastname: Wada
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D010243:Paralysis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D015995:Prevalence; D012189:Retrospective Studies; D013123:Spinal Fusion; D013166:Spondylitis / Q000453:epidemiology* / Q000382:microbiology* / Q000601:surgery; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013211:Staphylococcus aureus; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents