Abstract
Spondylodiscitis is arare disease with an increasing incidence. In this retrospective study 112 patients with spondylodiscitis surgically treated from 1 January 2005 to 31 December 2012 in alevelI spine center were investigated with respect to potential prognostic criteria. The time period covered by the investigation was the duration of hospitalization. The parameters analyzed were mortality, age, localization of the spondylodiscitis, detection of abscesses and pathogens, neurological status and body mass index (BMI). The average age of the patients was 68.3 years (±12.9 years). The mortality rate during hospitalization was 10.7% (N = 12). Older patients had asignificantly higher in-hospital mortality rate (p = 0.008). Abscess formation was found in 49.1% of the patients and was associated with asignificantly longer hospital stay (p = 0.001) and in the intensive care unit (ICU, p = 0.001) as well as ahigher risk of revision surgery (p = 0.018). In addition, obese patients had a significantly higher occurrence of abscesses (p = 0.034). Pathogen detection was successful in 60.7 % of the cases with Staphylococcus aureus as the most frequent pathogen. Detection of pathogens was associated with alonger hospital stay (p = 0.006) and a greater need of intensive care monitoring (p = 0.017). Patients with anephropathy had asignificantly increased mortality, longer duration of hospitalization and a more frequent occurrence of multilevel afflictions. Old age, abscess formation, positive detection of pathogens and renal failure can be used as prognostic criteria. Risk factors for formation of abscesses include a lumbar localization of spondylodiscitis, nephropathy as well as detection of a pathogen and obesity.
Highlights
Spondylodiscitis is a rare disease with an increasing incidence
In this retrospective study 112 patients with spondylodiscitis surgically treated from 1 January 2005 to 31 December 2012
in a level I spine center were investigated with respect to potential prognostic criteria
Summary
Die Spondylodiszitis wird als Infektion durch Erreger mit Befall der Bandscheibe und mit unterschiedlichem Ausmaß der angrenzenden Wirbelkörper definiert [1,2,3,4,5]. Insgesamt ist die Spondylodiszitis mit einer Inzidenz von 1:100.000 Bewohnern/ Jahr eine seltene Erkrankung [6, 9,10,11]. Bisher gibt es lediglich Hinweise darauf, dass das hohe Alter hinsichtlich der erhöhten „Inpatient“-Mortalität und Einjahresmortalität mit einer schlechteren Prognose einhergeht [11]. Außerdem haben das Alter über 75 Jahre, ein Nachweis von S. aureus sowie das Versagen der antibiotischen Therapie negativen Einfluss [5]. Wünschenswert wären auch Kriterien, welche den stationären Verlauf beeinflussen. Ziel dieses Beitrages ist es daher, ausgewählte, intrinsische Parameter hinsichtlich ihres Einflusses auf den stationären Verlauf bei Patienten mit Spondylodiszitis zu analysieren. Sollen Kriterien, welche möglicherweise eine Aussage über den stationären Verlauf zulassen, identifiziert werden
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