A Comprehensive Treatment Strategy for Severe Pyogenic Spondylitis, Including Orthopedic Surgery, in Compliance with Surviving Sepsis Campaign Guidelines

Abstract

Introduction: For severe cases of pyogenic spondylitis, we adhered to surviving sepsis campaign guidelines and performed orthopedic interventions with clear objectives and appropriate timing. We investigated the clinical factors and outcomes.

Methods: Twenty-seven consecutive patients with severe pyogenic spondylitis with extra-vertebral abscesses treated at the Emergency Center of Tohoku University Hospital over for 10 years from April 2008 were included in this study. From the electronic medical records, we investigated the diagnosis and treatment details, imaging findings, compliance with guidelines, and outcome.

Results: All patients were initially treated in compliance with the guidelines, and the causative organism was identified for all case except one. Puncture and/or curettage of the lesion for eradication of infection was performed in 25 patients (93%), and surgery was performed in 18 patients (67%); 1 patient died, and 26 patients survived (5 patients were discharged home and 21 patients were transferred to another hospital).

Conclusions: The comprehensive treatment strategy for severe pyogenic spondylitis of our institution was presented and the clinical outcomes were reported.