Asian Spine J > Volume 14(5); 2020 > Article |
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Author | Type of study | No. of patients | DM (%) | Immunocompromised (%) | Malignancy (%) | ESRD (%) | HIV (%) | IVDA (%) | Alcohol (%) | BMI >35 kg/m2 | Distal infection (%) |
---|---|---|---|---|---|---|---|---|---|---|---|
Alton et al. [68] (2015) | Single institutional retrospective review-cervical SEA only (7 yr) | 62 | 21 | - | - | 6.5 | - | 53.2 | - | 3.2 | |
Arko et al. [28] (2014) | PubMed search (15 yr) | 429 | 26.9 | - | - | 12.0a) | - | 21.6 | 13.1 | - | - |
Artenstein et al. [7] (2016) | 10-yr, retrospective, tertiary-care, regional, academic medical center | 162 | 30.4 | 6.8 | 6.0 | 1.6 | 14.8 | 15.2 | 17.2 | ||
Connor et al. [16] (2013) | Retrospective review of patient charts (11 yr) | 77 | 26.3 | 12.3 | 1.8 | 19.3 | 1.8 | 38.6 | |||
Ju et al. [103] (2015) | Single institutional retrospective review non-contiguous abscess (18 yr) | 233 | 25.8 | 16.7 | - | - | - | 18.5 | 17.6 | - | - |
Karikari et al. [42] (2009) | Retrospective, single institution (10 yr) | 104 | 33.6 | 9.6 | - | 19.2 | - | 1.92 | 4.8b) | - | 10.6c) |
Kim et al. [72] (2014) | Single institutional retrospective review (18 yr) | 355 | 26 | 15 | 16 | - | - | 20 | 22 | - | - |
Ma et al. [48] (2012) | Retrospective, single institution (24 yr) | 35 | 3 | 3 | |||||||
Shah et al. [44] (2018) | Single institutional retrospective review | 1,053 | 23 | 14 | 7.5 | 4.2 | 2.0 | 18 | 17 | 13 (>30 kg/m2) | 29.2 |
Shweikeh et al. [47] (2017) | Retrospective, single institution | 106 | 35.8 | 13.2 | 30.2 | 21.7 | |||||
Spernovasilis et al. [71] (2017) | Retrospective, single institution (medical treatment only) | 21 | 42.9 | 23.8 | 23.8 | ||||||
Suppiah et al. [66] (2016) | PubMed review (25 yr) | 1,843 | 27.6 | 11.2 | 12.2 | 13.2d) | 23.2 | 15.1 | 30.6e) | ||
Vakili et al. [8] (2017) | Single institutional retrospective review non-contiguous abscess (10 yr) | 101 | 26.7 | 3.0 | 4.0 | 5.0 | |||||
Ziu et al. [9] (2014) | Retrospective, single institution; all history of intravenous drug use (8 yr) | 102 | 7 | 2 | 3 | 100 | 12 | 9.8 |
Study | Staphylococcus aureus | MSSA | MRSA | Coagulase-negative Staphylococcus (such as epidermidis) | Streptococcus species | Gram-negative bacteria | Polymicrobial | None isolated | Other | Mycobacterium spp. |
---|---|---|---|---|---|---|---|---|---|---|
Alton et al. [68] (2015) | 70.9 | 38.6 | 32.3 | 1.6 | 17.7 | - | - | 16.3 | 1.6a) | - |
Arko et al. [28] (2014) | 63.6 | 38.9 | 19.9 | 7.5 | 6.8 | 8.1 | 4.9 | 13.9 | ||
Avanali R [104] (2016) | 69.6 | 34.8 | 30.4 | 4.3 | 13.0 | 8.7 | ||||
Baker et al. [4] (1975) | 53.8 | 7.6 | 12.8 | 10.3 | 12.8 | 2.6b) | - | |||
Connor et al. [16] (2013) | 61.1 | 29.9 | 31.2 | 2.6 | 9.1 | 20.8 | 1.3 | |||
Grewal S [105] (2006) | 74.8c) | 7 | 2.4 | 3.3 | 3.5 | 1.4d) | 1.1 | |||
Karikari et al. [42] (2009) | 60.6 | 31.8 | 28.8 | 9.6 | 4.8 | 10.6 | 11.5 | 2.9e) | - | |
Kim et al. [72] (2014) | 74.6 | 51.3 | 16.9 | 6.4 | 11.8 | 4.5 | 5.6 | 7.9 | 3.7 | - |
Ma et al. [48] (2012) | 53.8 | - | - | - | 15.3 | 7.6 | - | 62.9f) | ||
Patel et al. [10] (2014) | 70 | 40 | 30 | 4 | 6 | 3 | 2 | 10 | 5 | - |
Reihsaus et al. [3] (2000) | 73.1 | - | - | 4.6 | 7.7 | 4.9 | 3.3 | 8.1 | 0.12 | |
Sendi et al. [20] (2008) | 60 | 4.5 | 14 | 16.5 | <1 | |||||
Shah et al. [44] (2018) | 54 | 40 | 14 | 5.6 | 9.9 | 2.9 | 3.1 | 17 | 4.7g) | 1.3 |
Shweikeh et al. [47] (2017) | 43.75 | 12.5 | 31.25 | 6.25 | 18.75 | 18.75 | - | 12.5 | - | |
Spernovasilis et al. [71] (2017) | 35 | 19 | 14.3 | 15 | 10 | 20 | 0 | 10 | 0 | |
Suppiah et al. [66] (2016) | 64.1 | 43.6 | 20.5 | 8.0 | 9.0 | 3.3 | - | 12.5 | 4.6h) | - |
Vakili et al. [8] (2017) | 59.4 | 43.6 | 15.8 | 13.9i) | 4.9 | 3.0 | 16.8 | 2.0j) | ||
Ziu et al. [9] (2014) | 40 | 23 | - | - | 6 | 11 | 5 | 10 | - | - |
Values are presented as %.
MSSA, methicillin-sensitive Staphylococcus aureus ; MRSA, methicillin-resistant Staphylococcus aureus.
Listing of specific entities as listed in the literature cited:
Variable | Surgical | Medical |
---|---|---|
Age | Greater than 65 years of age [66,72,106]; greater than 50 years of age [26] | |
Co-morbidity | Diabetes mellitus [10,44,57,66,72,106]; active malignancy [44] | Non-diabetic |
C-reactive protein greater than 115 | Yes [10] | C-reactive protein less than 115 |
Leukocytosis greater than 12.5 | Yes [10] | Leukocytosis less than 12 |
Microbiology | Methicillin-resistant Staphylococcus aureus [66,71,72,106] | - |
Positive blood cultures | Yes [10] | No |
Sepsis | Yes [66] | No [66] |
Spinal level | Cervical [66,68,107] or cervicothoracic [66]; more than 5 level involvement [25] | Lumbar (below conus medullaris) [66]; abscess involvement is so extensive surgery is not feasible [26] |
Anatomic location | Dorsal circumferential [42] | Ventral [42]; dorsal location [44]a) |
Spinal instability | Instability [28,66] or pathologic or compression fracture at affected levels [44] | Stable [66] |
Baseline neurologic status | Neurologically symptomatic [16,66] especially with neurologic deficit involving spinal cord [72] or motor weakness on presentation [44]; pelagic for <72 hr [42]; Sendi [20]; neurologically symptoms of less than 36-hour duration [20,30,106]; a relative risk factor, but probably less predictive is sensory deficit on presentation [44] | Neurologically intact [5,43]; pelagic for >72 hr [20,42,108]; complete spinal cord injury ≥36 hr [16] to ≥48 hr prior to presentation [1] |
Decline in neurologic function | Yes [10] | No |
Radiographic findings | Ring-like enhancement on magnetic resonance imaging [109]b) | - |
a) Based on data of exclusively medically treated patients with low incidence of dorsal involvement.
b) Enhancement of the disc, vertebral body, or para-/intraspinal soft tissues is seen in 94%–100% of patients with “spinal infection”, however, may not be evident in severely immunocompromised patients [110].
Study | Type of study | No. of patients | Cervical | Cervicothoracic | Thoracic | Thoracolumbar | Lumbar | Lumbarsacral | Sacral |
---|---|---|---|---|---|---|---|---|---|
Amadoru et al. [11] 2017 | Single institutional retrospective review (>65 yr) | 34 | 6 | 12 | 76 | 6 | |||
Arko et al. [28] (2014) | PubMed review | 646 | 24 | 30.8 | - | 48.1 | |||
Artenstein et al. [7] (2016) | 10-year, retrospective, tertiary-care, regional, academic medical center | 162 | 25.9 | 34.0 | 56.2 | 29.0 | |||
Single institutional retrospective review (<65 yr) | 19 | 11 | 0 | 58 | 5 | ||||
Connor et al. [16] (2013) | Single institutional retrospective review (11 yr) | 77 | 23.4 | 50.6 | 26.0 | ||||
Karikari et al. [42] (2009) | Single institutional retrospective review (>10 yr) | 104 | 17.0 | 31.8 | 51.1 | ||||
Lener et al. [26] (2018) | Review | 24 | - | 31 | - | 48 | - | ||
Patel et al. [10] (2014) | Single institutional retrospective review (6 yr) | 128 | 35.9 | 39.1 | 54.7 | 23.4 | |||
Reihsaus et al. [3] (2000) | PubMed review | 725 | 19 | 7 | 35 | 7 | 18 | 12 | 0.4 |
Shah et al. [44] (2018) | Single institutional retrospective review (23 yr) | 1,053 | 13 | 5.5 | 21 | 6.7 | 29 | 19 | 0.19 |
Review (only medically treated) | 8.5 | 3.3 | 19 | 6.8 | 37 | 22 | 0.5 | ||
Siddiq et al. [29] (2004) | Institutional retrospective | 57 | 28 | - | 18 | - | 54 | - | |
Literature review only Streptococcus pneumoniae | 21 | 14.3 | 9.5 | 14.3 | - | 28.6 | 4.8 | - | |
Soehle et el. [21] (2002) | Single institutional retrospective review | 25 | 32 | 20 | 48 | ||||
Suppiah et al. [66] (2016) | PubMed review (25 yr) | 1,843 (based on 916 data points) | 22.5 | - | 33.2 | - | 48.1 | - | - |
Vakili et al. [8] (2017) | Single institutional retrospective review (10 yr) | 101 | 11.9 | 14.9 | 42.6 | ||||
Wang et al. [31] (2012) | Institutional prospective non-IVDA | 44 | 18 | 47 | 34 | ||||
Institutional prospective IVDA | 44 | 78 | - | 9 | - | 13 | - | - | |
Wheeler et al. [67] (1992) | Case report | 37 | 14–26 | - | 31–63 | - | 21–44 | - | |
Zimmerer et al. [41] (2011) | Single institutional prospective (4 yr) | 36 | 9.6 | 17.3 | 53.4 | 9.6 | |||
Ziu et al. [9] (2014) | Single institutional retrospective review (IVDA) | 34 | 8.8 | 23.5 | 57.8 |