Chien Yew Kow1, Patrick Chan1, Greg Etherington2, Lu Ton2, Susan Liew2, Allen C Cheng3, Jeffrey V Rosenfeld4. 1. Department of Neurosurgery, Alfred Hospital. 2. Department of Orthopaedics, Alfred Hospital. 3. Infection Prevention and Healthcare Epidemiology Unit, Alfred Hospital; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. 4. Department of Neurosurgery, Alfred Hospital; ; Department of Surgery, Monash University, Melbourne, Australia.
Abstract
BACKGROUND: Panspinal infection usually presents with fever, back pain, neurological deficit, and in advanced cases multi-organ failure and septic shock. The choice of treatment for panspinal infection is challenging because these patients are usually medically unstable with severe neurological compromise. The objective of this study is to review management and long term outcomes for patients with panspinal infection. METHODS: A retrospective review of patients with panspinal infection treated in our center over a 5-year period [Jan 2010-Dec 2014] and a review of the current published literatures was undertaken. RESULTS: We identified 4 patients with panspinal infection. One case was managed medically due to high perioperative risk, whilst the other three were managed surgically whilst on antibiotic therapy. All 3 cases managed surgically improved neurologically and infection subsided, whereas the patient managed medically did not change neurologically and infection subsided. CONCLUSIONS: Patients with panspinal infection should be treated surgically unless the medical risk of surgery or anaesthesia is prohibitive.
BACKGROUND:Panspinal infection usually presents with fever, back pain, neurological deficit, and in advanced cases multi-organ failure and septic shock. The choice of treatment for panspinal infection is challenging because these patients are usually medically unstable with severe neurological compromise. The objective of this study is to review management and long term outcomes for patients with panspinal infection. METHODS: A retrospective review of patients with panspinal infection treated in our center over a 5-year period [Jan 2010-Dec 2014] and a review of the current published literatures was undertaken. RESULTS: We identified 4 patients with panspinal infection. One case was managed medically due to high perioperative risk, whilst the other three were managed surgically whilst on antibiotic therapy. All 3 cases managed surgically improved neurologically and infection subsided, whereas the patient managed medically did not change neurologically and infection subsided. CONCLUSIONS:Patients with panspinal infection should be treated surgically unless the medical risk of surgery or anaesthesia is prohibitive.
Authors: Lorenzo Magrassi; Marco Mussa; Andrea Montalbetti; Marta Colaneri; Angela di Matteo; Antonello Malfitano; Anna Maria Simoncelli; Maria Grazia Egitto; Claudio Bernucci; Enrico Brunetti Journal: Front Surg Date: 2020-04-30