根据病原体检测情况调查脊椎骨髓炎后生活质量的改善情况。

Frank Beyer, Birte Wenk, Norma Jung, Jan Bredow, Peer Eysel, Ayla Yagdiran
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引用次数: 0

摘要

目的本研究旨在根据微生物采样中病原体的检测情况,比较椎体骨髓炎(VO)后的临床特征和生活质量(QoL):我们对一家三级转诊医院的前瞻性单中心研究进行了事后数据分析,研究对象包括 2008 年至 2020 年的椎体骨髓炎患者。数据收集于术前(T0)和术后 1 年(T1)。主要结果是QoL,通过Oswestry残疾指数和核心结果测量指数进行评估:结果:对133名接受手术治疗的胸椎或腰椎VO患者的数据进行了评估。100例(75.2%)患者(第1组)从术中培养样本中检测到病原体。33例(24.8%)患者(第2组)的培养结果为阴性。在 T1 阶段,两组患者的生活质量没有明显差异。我们观察到第一组患者术前 C 反应蛋白值较高,T0 时脊柱水肿发生率较高:结论:所有患者的生活质量在 T1 期均有明显改善,但得分仍与慢性背痛患者的得分相当。生活质量不受病原体检测的影响。然而,由于同时发现了菌血症和硬膜外脓肿等病原体,以及针对性抗生素治疗的优势,因此仍有必要尝试检测病原体。检测的最关键步骤可能是避免采样前使用抗生素。本文引用如前:Beyer F, Wenk B, Jung N, Bredow J, Eysel P, Yagdiran A. 根据病原体检测情况调查椎体骨髓炎后生活质量的改善。Acta Orthop Traumatol Turc., 2024; 10.5152/j.aott.2024.23073 [Epub Ahead of Print].
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An investigation into the quality of life improvements after vertebral osteomyelitis depending on the status of pathogen detection.

Objective: This study aimed to compare clinical characteristics and quality of life (QoL) after vertebral osteomyelitis (VO) based on the status of pathogen detection in microbiological sampling.

Methods: We conducted a post hoc data analysis from a prospective single-center study in a tertiary referral hospital, including VO patients from 2008 to 2020. Data were collected preoperatively (T0) and 1-year post surgery (T1). The primary outcome was QoL, assessed with the Oswestry Disability Index and Core Outcome Measures Index.

Results: Data from 133 patients with surgically treated thoracic or lumbar VO were evaluated. The pathogen was detected from cultured intraoperative samples in 100 (75.2%) patients (group 1). Culture remained negative in 33 (24.8%) patients (group 2). Quality of life did not differ significantly between the groups at T1. We observed higher preoperative C-reactive protein values and higher rates of spinal empyema at T0 in group 1.

Conclusion: Quality of life improved significantly for all patients at T1, but scores remained comparable to those reported by patients with chronic back pain. Quality of life was not affected by pathogen detection. However, attempts to detect pathogens are still indicated due to the concomitant findings, including bacteremia and epidural abscesses, along with the advantages of targeted antibiotic therapy. The most critical step for detection may be avoiding pre-sampling antibiotic administration. Cite this article as: Beyer F, Wenk B, Jung N, Bredow J, Eysel P, Yagdiran A. An investigation into quality of life improvements after vertebral osteomyelitis depending on the status of pathogen detection. Acta Orthop Traumatol Turc., 2024; 10.5152/j.aott.2024.23073 [Epub Ahead of Print].

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