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논문 기본 정보

자료유형
학술저널
저자정보
Lee, Yangwon (Department of Neurosurgery, Korea University Ansan Hospital) Kim, Bum-Joon (Department of Neurosurgery, Korea University Ansan Hospital) Kim, Se-Hoon (Department of Neurosurgery, Korea University Ansan Hospital) Lee, Seung-Hwan (Department of Neurosurgery, Korea University Ansan Hospital) Kim, Won-Hyung (Department of Neurosurgery, Korea University Ansan Hospital) Jin, Sung-Won (Department of Neurosurgery, Korea University Ansan Hospital)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제61권 제1호
발행연도
2018.1
수록면
81 - 88 (8page)

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Objective : Spondylitis is often chemotherapy resistant and requires long-term treatment. Without adequate chemotherapy, the outcome can be fatal or result in severe neurologic damage. Therefore, differentiating the etiology of spondylitis is very important, particularly in spontaneous cases. As the prevalence of tuberculosis in Korea has decreased in recent years, updated clinical research about spondylitis is warranted. Methods : From April 2010 to March 2016, data from spondylitis patients were collected retrospectively. In total, 69 patients (51 with pyogenic spondylitis and 18 with tuberculous spondylitis) were included. Clinical data, laboratory findings including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, measurements of Cobb angles at the initial and final follow-up, and radiologic features on magnetic resonance imaging (MRI) scans were evaluated. To test differences between the pyogenic and tuberculous groups, numerical data were compared using the student's t-test and Mann-Whitney U test, and categorical data were compared using the chi-square test and Fisher's exact test. Results : The patients' mean age was 60.0 years. Male sex was slightly predominant (56.5%). There was no difference in mean age and sex between the two groups. The pyogenic group had a relatively higher proportion of immunocompromised patients. The peak CRP value was higher in the pyogenic group than in the tuberculous group (14.08 mg/dL and 8.50 mg/dL, respectively, p=0.009), whereas the ESR was not significantly different between the groups (81.5 mm/h and 75.6 mm/h, respectively, p=0.442). Radiologically, the presence of disc space sparing and vertebral body collapse differed between the groups. In the tuberculous group, the disc was more commonly preserved on contrast-enhanced MRI (50% and 23.5%, respectively, p=0.044), and vertebral body collapse was more common (66.6% and 15.7%, respectively, p<0.001). The mean length of hospitalization was longer in the pyogenic group (56.5 days and 41.2 days, respectively, p=0.001). Four mortality cases were observed only in the pyogenic group. The most commonly isolated microorganism in the pyogenic group was Staphylococcus aureus(S. aureus) (methicillin susceptible S. aureus and methicillin resistant S. aureus [MRSA] in 8 and 4 cases, respectively). Conclusion : The clinical and radiological manifestations of spontaneous spondylitis differ based on the causative organism. Pyogenic spondylitis patients tend to have a higher CRP level and a more severe clinical course, whereas tuberculous spondylitis patients present with destruction of the vertebral body with disc sparing more frequently. The presence of MRSA is increasing in community-acquired spondylitis cases.
#Spondylitis #Osteomyelitis #Bone diseases #Infectious #Bacterial infection #Spondylodiscitis #Tuberculosis

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참고문헌 (6)

참고문헌 신청
Hoiby N / 2015 / ESCMID guideline for the diagnosis and treatment of biofilm infections 2014 / Clin Microbiol Infect 21(Suppl 1):S1~S25 Crossref Se-Jin Jeong / 2014 / Microbiology and Epidemiology of Infectious Spinal Disease / 대한신경외과학회지 56(1):21~27 google schola Jevtic V / 2004 / Vertebral infection / Eur Radiol 14(Suppl 3):E43~E52 Crossref 김희진 / 2012 / 한국에서의 결핵현황 / 대한내과학회지 82(3):257~262 dbpia 정희진 / 2014 / Clinical Guidelines for the Antimicrobial Treatment of Bone and Joint Infections in Korea / Infection and Chemotherapy 46(2):125~138 dbpia

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