Balcescu Cristian, Odeh Khalid, Rosinski Alexander, Nudelman Brandon, Schlauch Adam, Shah Ishan, Ungurean Victor, Prasad Priya, Leasure Jeremi, Stepansky Flora, Piple Amit, Kondrashov Dimitriy
San Francisco Orthopaedic Residency Program, St. Mary's Medical Center, San Francisco, CA 94117, USA.
The Taylor Collaboration, San Francisco, CA 94117, USA.
J Bone Jt Infect. 2023 Jan 3;8(1):1-9. doi: 10.5194/jbji-8-1-2023. eCollection 2023.
: retrospective case series. : the presenting clinical symptoms of spinal infections are often nonspecific and a delay in diagnosis can lead to adverse patient outcomes. The morbidity and mortality of patients with multifocal spinal infections is significantly higher compared to unifocal infections. The purpose of the current study was to analyse the risk factors for multifocal spinal infections. : we conducted a retrospective review of all pyogenic non-tuberculous spinal infections treated surgically at a single tertiary care medical center from 2006-2020. The medical records, imaging studies, and laboratory data of 43 patients during this time period were reviewed and analysed after receiving Institutional Review Board approval. Univariate and multivariate analyses were performed to identify factors associated with a multifocal spinal infection. : 15 patients (35 %) had multifocal infections. In univariate analysis, there was a significant association with chronic kidney disease ( ), gender ( ), a white blood cell count ( ), and cervical ( ) or thoracic ( .001) involvement. In multivariate analysis, both cervical and thoracic involvement remained statistically significant ( and , respectively). : patients with infections in the thoracic or cervical region are more likely to have a multifocal infection. Multifocal pyogenic spinal infections remain a common entity and a total spine MRI should be performed to aid in prompt diagnosis.
回顾性病例系列研究。脊柱感染的临床症状通常不具有特异性，诊断延迟可能导致患者出现不良预后。与单灶性感染相比，多灶性脊柱感染患者的发病率和死亡率显著更高。本研究的目的是分析多灶性脊柱感染的危险因素。我们对2006年至2020年在一家三级医疗中心接受手术治疗的所有化脓性非结核性脊柱感染进行了回顾性研究。在获得机构审查委员会批准后，对这一时期43例患者的病历、影像学检查和实验室数据进行了回顾和分析。进行单因素和多因素分析以确定与多灶性脊柱感染相关的因素。15例患者（35%）患有多灶性感染。在单因素分析中，与慢性肾病、性别、白细胞计数以及颈椎或胸椎受累存在显著相关性（P值分别为……）。在多因素分析中，颈椎和胸椎受累在统计学上仍具有显著意义（P值分别为……）。胸椎或颈椎区域感染的患者更有可能发生多灶性感染。多灶性化脓性脊柱感染仍然是一种常见疾病，应进行全脊柱磁共振成像以帮助及时诊断。
