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Research ArticleResearch Article

Management of Pyogenic Spondylodiscitis Following Nonspinal Surgeries: A Tertiary Care Center Experience

Ghazwan A. Hasan, Hayder Q. Raheem, Ahmed Qutub, Yasameen Bani Wais, Mustafa Hayder Katran and Gautam M. Shetty
International Journal of Spine Surgery May 2021, 8080; DOI: https://doi.org/10.14444/8080
Ghazwan A. Hasan
1Department of Orthopaedic Surgery, Al-Kindi Teaching Hospital, Baghdad, Iraq
MD
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Hayder Q. Raheem
2Al-Mustansiria Medical College, Baghdad, Iraq
MD
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Ahmed Qutub
3Imam Zain Alabdine Hospital, Karbala, Iraq
MD
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Yasameen Bani Wais
4Private Clinic, Baghdad, Iraq
MD
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Mustafa Hayder Katran
2Al-Mustansiria Medical College, Baghdad, Iraq
MD
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Gautam M. Shetty
5Orthopaedic & Knee Clinic, Mumbai, India
6AIMD Research, Mumbai, India
MSOrth
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ABSTRACT

Background The literature is lacking on the incidence and management of pyogenic spondylodiscitis (PS) following routine elective surgical procedures. This study aimed to analyze the presentation and treatment outcome in patients with PS following nonspinal surgeries at a tertiary care center with a minimum follow-up of 12 months.

Methods The demographic, clinical-radiologic features, and treatment outcomes in 40 patients with a diagnosis of PS following nonspinal surgical procedures were retrospectively reviewed and analyzed.

Results The mean age at presentation was 36.4 ± 11.8 years, with 80% of patients being female. The common surgical procedures associated with PS were cesarean delivery (30%), gastric sleeve surgery (12.5%), and dilatation and curettage (12.5%). The tissue biopsy culture was positive in 82.5% of patients. A total of 26 patients (65%) were treated with conservative management and 14 patients (35%) were treated surgically. The mean pretreatment Core Outcome Measure Index score significantly decreased at 12 months (P < .0001) after treatment. The mean pretreatment erythrocyte sedimentation rate (P < .0001) and C-reactive protein (P < .0001) levels significantly decreased at 12 months after treatment.

Conclusions With most patients with PS following nonspinal surgeries treated with conservative management, excellent clinical outcomes were achieved in all patients at 12 months after treatment. The diagnosis of PS should be considered in patients presenting with low back pain (LBP) with a recent history of undergoing a nonspinal surgical procedure. Patients who undergo surgical procedures are an important “at-risk” patient population, and early diagnosis and treatment can help achieve excellent clinical outcomes. Further studies are required to determine risk factors and possible perioperative precautions that can be taken to prevent PS in patients who undergo nonspine surgeries.

Level of Evidence 3.

Clinical Relevance Pyogenic spondylodiscitis should be suspected in patients presenting with LBP after a recent non-spinal surgical procedure. Early diagnosis and treatment can help achieve excellent clinical outcomes in these patients.

  • pyogenic spondylodiscitis
  • spinal infections
  • outcome
  • infection
  • surgery

Footnotes

  • Disclosures and COI: No benefits or funds were received in support of this study by any of the authors. This study has been approved by an Institutional Review Board and ethics committee and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

  • This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Management of Pyogenic Spondylodiscitis Following Nonspinal Surgeries: A Tertiary Care Center Experience
Ghazwan A. Hasan, Hayder Q. Raheem, Ahmed Qutub, Yasameen Bani Wais, Mustafa Hayder Katran, Gautam M. Shetty
International Journal of Spine Surgery May 2021, 8080; DOI: 10.14444/8080

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Management of Pyogenic Spondylodiscitis Following Nonspinal Surgeries: A Tertiary Care Center Experience
Ghazwan A. Hasan, Hayder Q. Raheem, Ahmed Qutub, Yasameen Bani Wais, Mustafa Hayder Katran, Gautam M. Shetty
International Journal of Spine Surgery May 2021, 8080; DOI: 10.14444/8080
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Keywords

  • pyogenic spondylodiscitis
  • spinal infections
  • outcome
  • infection
  • surgery

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