Management of Thoracic Spine Infections

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Infections of the spine are a serious medical problem that, if untreated, can result in severe disability. Advances in diagnostic imaging, antimicrobial therapy, and surgical techniques have significantly improved the prognosis of patients harboring spinal infections. The unique anatomy of the thoracic spine may influence infections in this region to be managed differently than similar lesions in the cervical and lumbar spine. This report focuses specifically on the management of thoracic spine infections.

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Epidemiology

Vertebral osteomyelitis represents 2% to 8% of all cases of osteomyelitis.2, 5 In a review of 62 patients with hematogenous osteomyelitis, Waldovogel and Papageorgious reported a 19% incidence of vertebral osteomyelitis, third only to involvement of the femur and tibia.9 Although affecting all age groups, the disease has a predilection for the elderly; most patients are between sixty and seventy years of age.10 Severe sequelae such as paralysis are also more common in the elderly.11 In a review

Epidemiology

An epidural abscess is a pyogenic infectious process of the epidural space. The reported incidence ranges from 0.2 to 1.2 cases per 10,000 patient admissions to 7.3%.13, 26 Spondylodiscitis is more prone to result in epidural abscess in the thoracic and lumbar spine. The cervical spine has been the least common site of involvement.27 Neurologic deficit most often occurs with lesions in the thoracic spine by two mechanisms: first, the localized accumulation of pus may cause spinal cord

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