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Spinal Infections

  • Hideki NagashimaEmail author
Chapter
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Abstract

The number of spinal infections seems to have increased as a result of increasing aging population, immunocompromised hosts, or intravenous drug users. For early diagnosis of spinal infection, magnetic resonance imaging is a useful tool that can yield positive results just 3 to 5 days after onset. Organism identification is very important for selecting appropriate antibiotics. Therefore, specimens must be collected from the locus of infection for culture in addition to blood cultures before the administration of antibiotics, even in the elderly. Staphylococcus aureus is the most commonly isolated pathogen. In elderly patients with implants such as pacemakers, prosthetic joints, and other prosthetic materials, Staphylococcus epidermidis is a possible pathogen. Escherichia coli and Proteus species from genitourinary tract infections are more likely in the elderly. The elderly are more frequently infected with drug-resistant pathogens. Based on pathogens identified from culture material, appropriate antibiotic selection should involve consideration of antimicrobial susceptibility and spinal tissue penetration. Although the optimal duration remains unknown, antimicrobial therapy for spinal infections should be longer than for most other types of infections. The gold standard surgical treatment for spinal infection is radical debridement followed by autologous strut bone grafting. Recently, the addition of posterior instrumentation has become popular. In the elderly, posterior instrumentation without anterior manipulation is an alternative surgical option. If there is dramatic pain relief, observation can be reasonable. If pain relief is inadequate or there is a possibility of progressive deformity, additional anterior debridement and bone grafting could be scheduled.

Keywords

Spine Infection Elderly Diagnosis Management 

References

  1. 1.
    Acosta FL Jr, Chin CT, Quinones-Hinojosa A, Ames CP, Weinstein PR, Chou D (2004) Diagnosis and management of adult pyogenic osteomyelitis of the cervical spine. Neurosurg Focus 17:E2PubMedCrossRefGoogle Scholar
  2. 2.
    Acosta FL Jr, Galvez LF, Aryan HE, Ames CP (2006) Recent advances: infections of the spine. Curr Infect Dis Rep 8:390–393PubMedCrossRefGoogle Scholar
  3. 3.
    Adatepe MH, Powell OM, Isaacs GH, Nichols K, Cefola R (1986) Hematogenous pyogenic vertebral osteomyelitis: diagnostic value of radionuclide bone imaging. J Nucl Med 27:1680–1685PubMedGoogle Scholar
  4. 4.
    Aldridge KE, Ashcraft DS (1997) Comparison of the in vitro activities of Bay 12–8039, a new quinolone, and other antimicrobials against clinically important anaerobes. Antimicrob Agents Chemother 41:709–711PubMedPubMedCentralGoogle Scholar
  5. 5.
    Ambrose GB, Alpert M, Neer CS (1966) Vertebral osteomyelitis. A diagnostic problem. JAMA 197:619–622PubMedCrossRefGoogle Scholar
  6. 6.
    Archer GL (1990) Staphylococcus epidermidis and other coagulase negative staphylococci. In: Mandell GL, Douglas RG, Bennett JE (eds) Principles and practice of infectious diseases. Churchill Livingstone, New York, pp 1511–1518Google Scholar
  7. 7.
    Arkader R, Troster EJ, Lopes MR, Junior RR, Carcillo JA, Leone C, Okay TS (2006) Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome. Arch Dis Child 91:117–120PubMedCrossRefGoogle Scholar
  8. 8.
    Barber M (1961) Methicillin-resistant staphylococci. J Clin Pathol 14:385–393PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Bateman JL, Pevzner MM (1995) Spinal osteomyelitis: a review of 10 years’ experience. Orthopedics 18:561–565PubMedGoogle Scholar
  10. 10.
    Belzunegui J, Del Val N, Intxausti JJ, De Dios JR, Queiro R, Gonzalez C, Rodriguez-Valverde V, Figueroa M (1999) Vertebral osteomyelitis in northern Spain. Report of 62 cases. Clin Exp Rheumatol 17:447–452PubMedGoogle Scholar
  11. 11.
    Belzunegui J, Intxausti JJ, De Dios JR, Del Val N, Rodriguez Valverde V, Gonzalez C, Queiro R, Figueroa M (2000) Haematogenous vertebral osteomyelitis in the elderly. Clin Rheumatol 19:344–347PubMedCrossRefGoogle Scholar
  12. 12.
    Bender CE, Berquist TH, Wold LE (1986) Imaging-assisted percutaneous biopsy of the thoracic spine. Mayo Clin Proc 61:942–950PubMedCrossRefGoogle Scholar
  13. 13.
    Berk RH, Yazici M, Atabey N, Ozdamar OS, Pabuccuoglu U, Alici E (1996) Detection of Mycobacterium tuberculosis in formaldehyde solution-fixed, paraffin-embedded tissue by polymerase chain reaction in Pott’s disease. Spine (Phila Pa 1976) 21:1991–1995CrossRefGoogle Scholar
  14. 14.
    Beronius M, Bergman B, Andersson R (2001) Vertebral osteomyelitis in Goteborg, Sweden: a retrospective study of patients during 1990–95. Scand J Infect Dis 33:527–532PubMedCrossRefGoogle Scholar
  15. 15.
    Bhagat S, Mathieson C, Jandhyala R, Johnston R (2007) Spondylodiscitis (disc space infection) associated with negative microbiological tests: comparison of outcome of suspected disc space infections to documented non-tuberculous pyogenic discitis. Br J Neurosurg 21:473–477PubMedCrossRefGoogle Scholar
  16. 16.
    Bontoux D, Codello L, Debiais F, Lambert de Cursay G, Azais I, Alcalay M (1992) Infectious spondylodiscitis. Analysis of a series of 105 cases. Rev Rhum Mal Osteoartic 59:401–407PubMedGoogle Scholar
  17. 17.
    Borowski AM, Crow WN, Hadjipavlou AG, Chaljub G, Mader J, Cesani F, vanSonnenberg E (1998) Interventional radiology case conference: the University of Texas Medical Branch. Percutaneous management of pyogenic spondylodiskitis. AJR Am J Roentgenol 170:1587–1592PubMedCrossRefGoogle Scholar
  18. 18.
    Boscia JA, Kobasa WD, Knight RA, Abrutyn E, Levison ME, Kaye D (1986) Epidemiology of bacteriuria in an elderly ambulatory population. Am J Med 80:208–214PubMedCrossRefGoogle Scholar
  19. 19.
    Boscia JA, Kobasa WD, Knight RA, Abrutyn E, Levison ME, Kaye D (1987) Therapy vs no therapy for bacteriuria in elderly ambulatory nonhospitalized women. JAMA 257:1067–1071PubMedCrossRefGoogle Scholar
  20. 20.
    Brueggemann AB, Kugler KC, Doern GV (1997) In vitro activity of BAY 12–8039, a novel 8-methoxyquinolone, compared to activities of six fluoroquinolones against Streptococcus pneumoniae. Haemophilus influenzae, and Moraxella catarrhalis. Antimicrob Agents Chemother 41:1594–1597PubMedPubMedCentralGoogle Scholar
  21. 21.
    Butler JS, Shelly MJ, Timlin M, Powderly WG, O’Byrne JM (2006) Nontuberculous pyogenic spinal infection in adults: a 12-year experience from a tertiary referral center. Spine (Phila Pa 1976) 31:2695–2700CrossRefGoogle Scholar
  22. 22.
    Cahill DW, Love LC, Rechtine GR (1991) Pyogenic osteomyelitis of the spine in the elderly. J Neurosurg 74:878–886PubMedCrossRefGoogle Scholar
  23. 23.
    Calderone RR, Larsen JM (1996) Overview and classification of spinal infections. Orthop Clin North Am 27:1–8PubMedGoogle Scholar
  24. 24.
    Carragee EJ (1997) Pyogenic vertebral osteomyelitis. J Bone Joint Surg Am 79:874–880PubMedCrossRefGoogle Scholar
  25. 25.
    Chelsom J, Solberg CO (1998) Vertebral osteomyelitis at a Norwegian university hospital 1987–97: clinical features, laboratory findings and outcome. Scand J Infect Dis 30:147–151PubMedCrossRefGoogle Scholar
  26. 26.
    Chew FS, Kline MJ (2001) Diagnostic yield of CT-guided percutaneous aspiration procedures in suspected spontaneous infectious diskitis. Radiology 218:211–214PubMedCrossRefGoogle Scholar
  27. 27.
    Childs SJ, Egan RJ (1996) Bacteriuria and urinary infections in the elderly. Urol Clin North Am 23:43–54PubMedCrossRefGoogle Scholar
  28. 28.
    Clavo-Sanchez AJ, Giron-Gonzalez JA, Lopez-Prieto D, Canueto-Quintero J, Sanchez-Porto A, Vergara-Campos A, Marin-Casanova P, Cordoba-Dona JA (1997) Multivariate analysis of risk factors for infection due to penicillin-resistant and multidrug-resistant Streptococcus pneumoniae: a multicenter study. Clin Infect Dis 24:1052–1059PubMedCrossRefGoogle Scholar
  29. 29.
    Collert S (1977) Osteomyelitis of the spine. Acta Orthop Scand 48:283–290PubMedCrossRefGoogle Scholar
  30. 30.
    Colmenero JD, Jimenez-Mejias ME, Sanchez-Lora FJ, Reguera JM, Palomino-Nicas J, Martos F, Garcia de las Heras J, Pachon J (1997) Pyogenic, tuberculous, and brucellar vertebral osteomyelitis: a descriptive and comparative study of 219 cases. Ann Rheum Dis 56:709–715PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Colmenero JD, Jimenez-Mejias ME, Reguera JM, Palomino-Nicas J, Ruiz-Mesa JD, Marquez-Rivas J, Lozano A, Pachon J (2004) Tuberculous vertebral osteomyelitis in the new millennium: still a diagnostic and therapeutic challenge. Eur J Clin Microbiol Infect Dis 23:477–483PubMedCrossRefGoogle Scholar
  32. 32.
    Cooppan R, Schoenbaum S, Younger MD, Freidberg S, D’Elia J (1976) Vertebral osteomyelitis in insulin-dependent diabetics. S Afr Med J 50:1993–1996PubMedGoogle Scholar
  33. 33.
    Cottle L, Riordan T (2008) Infectious spondylodiscitis. J Infect 56:401–412PubMedCrossRefGoogle Scholar
  34. 34.
    Coventry MB, Ghormley RK, Kernohan JW (1945) The intervertebral disc: its microscopic anatomy and pathology: part I. anatomy, development, and physiology. J Bone Joint Surg Am 27:13Google Scholar
  35. 35.
    Cunha BA (2002) Osteomyelitis in elderly patients. Clin Infect Dis 35:287–293PubMedCrossRefGoogle Scholar
  36. 36.
    Currie MS (1992) Immunosenescence. Compr Ther 18:26–34PubMedGoogle Scholar
  37. 37.
    Currier BL, Banovac K, Eismont FJ (1994) Gentamicin penetration into normal rabbit nucleus pulposus. Spine (Phila Pa 1976) 19:2614–2618CrossRefGoogle Scholar
  38. 38.
    Dagirmanjian A, Schils J, McHenry M, Modic MT (1996) MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol 167:1539–1543PubMedCrossRefGoogle Scholar
  39. 39.
    Dai LY, Chen WH, Jiang LS (2008) Anterior instrumentation for the treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine. Eur Spine J 17:1027–1034PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Dalhoff A, Petersen U, Endermann R (1996) In vitro activity of BAY 12–8039, a new 8-methoxyquinolone. Chemotherapy 42:410–425PubMedCrossRefGoogle Scholar
  41. 41.
    Daniel TM (1990) The rapid diagnosis of tuberculosis: a selective review. J Lab Clin Med 116:277–282PubMedGoogle Scholar
  42. 42.
    de Lucas EM, Gonzalez Mandly A, Gutierrez A, Pellon R, Martin-Cuesta L, Izquierdo J, Sanchez E, Ruiz E, Quintana F (2009) CT-guided fine-needle aspiration in vertebral osteomyelitis: true usefulness of a common practice. Clin Rheumatol 28:315–320PubMedCrossRefGoogle Scholar
  43. 43.
    Devereaux MD, Hazelton RA (1983) Pyogenic spinal osteomyelitis--its clinical and radiological presentation. J Rheumatol 10:491–493PubMedGoogle Scholar
  44. 44.
    Diekema DJ, Pfaller MA, Schmitz FJ, Smayevsky J, Bell J, Jones RN, Beach M (2001) Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997–1999. Clin Infect Dis 32(Suppl 2):S114–S132PubMedCrossRefGoogle Scholar
  45. 45.
    Dietze DD Jr, Fessler RG, Jacob RP (1997) Primary reconstruction for spinal infections. J Neurosurg 86:981–989PubMedCrossRefGoogle Scholar
  46. 46.
    Digby JM, Kersley JB (1979) Pyogenic non-tuberculous spinal infection: an analysis of thirty cases. J Bone Joint Surg Br 61:47–55PubMedGoogle Scholar
  47. 47.
    Dimar JR, Carreon LY, Glassman SD, Campbell MJ, Hartman MJ, Johnson JR (2004) Treatment of pyogenic vertebral osteomyelitis with anterior debridement and fusion followed by delayed posterior spinal fusion. Spine (Phila Pa 1976) 29:326–332; discussion 332CrossRefGoogle Scholar
  48. 48.
    Doub HP, Badgley CE (1932) The roentgen signs of tuberculosis of the vertebral body. Am J Radiol 27:11Google Scholar
  49. 49.
    Eismont FJ, Bohlman HH, Soni PL, Goldberg VM, Freehafer AA (1983) Pyogenic and fungal vertebral osteomyelitis with paralysis. J Bone Joint Surg Am 65:19–29PubMedCrossRefGoogle Scholar
  50. 50.
    Eismont FJ, Green BA, Brown MD, Ghandur-Mnaymneh L (1987) Coexistent infection and tumor of the spine. A report of three cases. J Bone Joint Surg Am 69:452–458PubMedCrossRefGoogle Scholar
  51. 51.
    Emery SE, Chan DP, Woodward HR (1989) Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting. Spine (Phila Pa 1976) 14:284–291Google Scholar
  52. 52.
    Enoch DA, Cargill JS, Laing R, Herbert S, Corrah TW, Brown NM (2008) Value of CT-guided biopsy in the diagnosis of septic discitis. J Clin Pathol 61:750–753PubMedCrossRefGoogle Scholar
  53. 53.
    Espersen F, Frimodt-Moller N, Thamdrup Rosdahl V, Skinhoj P, Bentzon MW (1991) Changing pattern of bone and joint infections due to Staphylococcus aureus: study of cases of bacteremia in Denmark, 1959–1988. Rev Infect Dis 13:347–358PubMedCrossRefGoogle Scholar
  54. 54.
    Fayazi AH, Ludwig SC, Dabbah M, Bryan Butler R, Gelb DE (2004) Preliminary results of staged anterior debridement and reconstruction using titanium mesh cages in the treatment of thoracolumbar vertebral osteomyelitis. Spine J 4:388–395PubMedCrossRefGoogle Scholar
  55. 55.
    Fellander M (1975) Paraplegia in spondylitis: results of operative treatment. Paraplegia 13:75–88PubMedCrossRefGoogle Scholar
  56. 56.
    Ferrara AM (2007) A brief review of moxifloxacin in the treatment of elderly patients with community-acquired pneumonia (CAP). Clin Interv Aging 2:179–187PubMedPubMedCentralGoogle Scholar
  57. 57.
    Fraimow HS (2009) Systemic antimicrobial therapy in osteomyelitis. Semin Plast Surg 23:90–99PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Frederickson B, Yuan H, Olans R (1978) Management and outcome of pyogenic vertebral osteomyelitis. Clin Orthop Relat Res 131:160–167Google Scholar
  59. 59.
    Fukuta S, Miyamoto K, Masuda T, Hosoe H, Kodama H, Nishimoto H, Sakaeda H, Shimizu K (2003) Two-stage (posterior and anterior) surgical treatment using posterior spinal instrumentation for pyogenic and tuberculotic spondylitis. Spine (Phila Pa 1976) 28:E302–E308Google Scholar
  60. 60.
    Garcia A Jr, Grantham SA (1960) Hematogenous pyogenic vertebral osteomyelitis. J Bone Joint Surg Am 42-a:429–436PubMedCrossRefGoogle Scholar
  61. 61.
    Gasbarrini AL, Bertoldi E, Mazzetti M, Fini L, Terzi S, Gonella F, Mirabile L, Barbanti Brodano G, Furno A, Gasbarrini A, Boriani S (2005) Clinical features, diagnostic and therapeutic approaches to haematogenous vertebral osteomyelitis. Eur Rev Med Pharmacol Sci 9:53–66PubMedGoogle Scholar
  62. 62.
    Gentry LO, Rodriguez GG (1990) Oral ciprofloxacin compared with parenteral antibiotics in the treatment of osteomyelitis. Antimicrob Agents Chemother 34:40–43PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Gepstein R, Folman Y, Lidor C, Barchilon V, Catz A, Hallel T (1992) Management of pyogenic vertebral osteomyelitis with spinal cord compression in the elderly. Paraplegia 30:795–798PubMedCrossRefGoogle Scholar
  64. 64.
    Goldstein EJ, Citron DM, Hudspeth M, Hunt Gerardo S, Merriam CV (1997) In vitro activity of Bay 12–8039, a new 8-methoxyquinolone, compared to the activities of 11 other oral antimicrobial agents against 390 aerobic and anaerobic bacteria isolated from human and animal bite wound skin and soft tissue infections in humans. Antimicrob Agents Chemother 41:1552–1557PubMedPubMedCentralGoogle Scholar
  65. 65.
    Gorensek M, Kosak R, Travnik L, Vengust R (2013) Posterior instrumentation, anterior column reconstruction with single posterior approach for treatment of pyogenic osteomyelitis of thoracic and lumbar spine. Eur Spine J 22:633–641PubMedCrossRefGoogle Scholar
  66. 66.
    Govender S (2005) Spinal infections. J Bone Joint Surg Br 87:1454–1458PubMedCrossRefGoogle Scholar
  67. 67.
    Grados F, Lescure FX, Senneville E, Flipo RM, Schmit JL, Fardellone P (2007) Suggestions for managing pyogenic (non-tuberculous) discitis in adults. Joint Bone Spine 74:133–139PubMedCrossRefGoogle Scholar
  68. 68.
    Graham SM, Fishlock A, Millner P, Sandoe J (2013) The management gram-negative bacterial haematogenous vertebral osteomyelitis: a case series of diagnosis, treatment and therapeutic outcomes. Eur Spine J 22:1845–1853PubMedPubMedCentralCrossRefGoogle Scholar
  69. 69.
    Graziano GP, Sidhu KS (1993) Salvage reconstruction in acute and late sequelae from pyogenic thoracolumbar infection. J Spinal Disord 6:199–207PubMedCrossRefGoogle Scholar
  70. 70.
    Hadjipavlou AG, Mader JT, Necessary JT, Muffoletto AJ (2000) Hematogenous pyogenic spinal infections and their surgical management. Spine (Phila Pa 1976) 25:1668–1679CrossRefGoogle Scholar
  71. 71.
    Hatch ES (1931) Acute osteomyelitis of the spine. Report of case with recovery. Review of the literature. New Orleans Med Surg J 83:13Google Scholar
  72. 72.
    Hee HT, Majd ME, Holt RT, Pienkowski D (2002) Better treatment of vertebral osteomyelitis using posterior stabilization and titanium mesh cages. J Spinal Disord Tech 15:149–156; discussion 156PubMedCrossRefGoogle Scholar
  73. 73.
    Henriques CQ (1958) Osteomyelitis as a complication in urology; with special reference to the paravertebral venous plexus. Br J Surg 46:19–28PubMedCrossRefGoogle Scholar
  74. 74.
    Henson SW Jr, Coventry MB (1956) Osteomyelitis of the vertebrae as the result of infection of the urinary tract. Surg Gynecol Obstet 102:207–214PubMedGoogle Scholar
  75. 75.
    Hirakawa A, Miyamoto K, Masuda T, Fukuta S, Hosoe H, Iinuma N, Iwai C, Nishimoto H, Shimizu K (2010) Surgical outcome of 2-stage (posterior and anterior) surgical treatment using spinal instrumentation for tuberculous spondylitis. J Spinal Disord Tech 23:133–138PubMedCrossRefGoogle Scholar
  76. 76.
    Hodgson AR, Stock FE (1956) Anterior spinal fusion a preliminary communication on the radical treatment of Pott’s disease and Pott’s paraplegia. Br J Surg 44:266–275PubMedCrossRefGoogle Scholar
  77. 77.
    Hopkinson N, Stevenson J, Benjamin S (2001) A case ascertainment study of septic discitis: clinical, microbiological and radiological features. QJM 94:465–470PubMedCrossRefGoogle Scholar
  78. 78.
    Iqbal P, Castleden CM (1997) Management of urinary incontinence in the elderly. Gerontology 43:151–157PubMedCrossRefGoogle Scholar
  79. 79.
    Irwin AD, Carrol ED (2011) Procalcitonin. Arch Dis Child Educ Pract Ed 96:228–233PubMedCrossRefGoogle Scholar
  80. 80.
    Isenberg Y, Parada JP (2010) Spontaneous vertebral osteomyelitis due to Staphylococcus epidermidis. J Med Microbiol 59:599–601PubMedCrossRefGoogle Scholar
  81. 81.
    Jaramillo-de la Torre JJ, Bohinski RJ, Kuntz C t (2006) Vertebral osteomyelitis. Neurosurg Clin N Am 17(339–51):viiGoogle Scholar
  82. 82.
    Jaye DL, Waites KB (1997) Clinical applications of C-reactive protein in pediatrics. Pediatr Infect Dis J 16:735–746; quiz 746–7PubMedCrossRefGoogle Scholar
  83. 83.
    Jensen AG, Espersen F, Skinhoj P, Frimodt-Moller N (1998) Bacteremic Staphylococcus aureus spondylitis. Arch Intern Med 158:509–517PubMedCrossRefGoogle Scholar
  84. 84.
    Ji B, Lounis N, Maslo C, Truffot-Pernot C, Bonnafous P, Grosset J (1998) In vitro and in vivo activities of moxifloxacin and clinafloxacin against Mycobacterium tuberculosis. Antimicrob Agents Chemother 42:2066–2069PubMedPubMedCentralGoogle Scholar
  85. 85.
    Jimenez-Mejias ME, de Dios Colmenero J, Sanchez-Lora FJ, Palomino-Nicas J, Reguera JM, Garcia de la Heras J, Garcia-Ordonez MA, Pachon J (1999) Postoperative spondylodiskitis: etiology, clinical findings, prognosis, and comparison with nonoperative pyogenic spondylodiskitis. Clin Infect Dis 29:339–345PubMedCrossRefGoogle Scholar
  86. 86.
    Joughin E, McDougall C, Parfitt C, Yong-Hing K, Kirkaldy-Willis WH (1991) Causes and clinical management of vertebral osteomyelitis in Saskatchewan. Spine (Phila Pa 1976) 16:261–264CrossRefGoogle Scholar
  87. 87.
    Kemp HB, Jackson JW, Shaw NC (1974) Laminectomy in paraplegia due to infective spondylosis. Br J Surg 61:66–72PubMedCrossRefGoogle Scholar
  88. 88.
    Kim NH, Lee HM, Suh JS (1994) Magnetic resonance imaging for the diagnosis of tuberculous spondylitis. Spine (Phila Pa 1976) 19:2451–2455CrossRefGoogle Scholar
  89. 89.
    Kim SH, Choi SJ, Kim HB, Kim NJ, Oh MD, Choe KW (2007) Diagnostic usefulness of a T-cell based assay for extrapulmonary tuberculosis. Arch Intern Med 167:2255–2259PubMedCrossRefGoogle Scholar
  90. 90.
    Kim CW, Currier BL, Eismont FJ (2011) Infections of the Spine. In: Herkowitz HN, Garfin SR, Eismont FJ, Bell GR, Balderston RA (eds) Rothman-Simeone the spine, vol 2. Elsevier Saunders, Philadelphia, pp 1513–1570CrossRefGoogle Scholar
  91. 91.
    King DM, Mayo KM (1973) Infective lesions of the vertebral column. Clin Orthop Relat Res 96:248–253Google Scholar
  92. 92.
    Koppel BS, Tuchman AJ, Mangiardi JR, Daras M, Weitzner I (1988) Epidural spinal infection in intravenous drug abusers. Arch Neurol 45:1331–1337PubMedCrossRefGoogle Scholar
  93. 93.
    Korovessis P, Petsinis G, Koureas G, Iliopoulos P, Zacharatos S (2006) Anterior surgery with insertion of titanium mesh cage and posterior instrumented fusion performed sequentially on the same day under one anesthesia for septic spondylitis of thoracolumbar spine: is the use of titanium mesh cages safe? Spine (Phila Pa 1976) 31:1014–1019CrossRefGoogle Scholar
  94. 94.
    Korovessis P, Petsinis G, Koureas G, Iliopoulos P, Zacharatos S (2006) One-stage combined surgery with mesh cages for treatment of septic spondylitis. Clin Orthop Relat Res 444:51–59PubMedCrossRefGoogle Scholar
  95. 95.
    Kowalski TJ, Berbari EF, Huddleston PM, Steckelberg JM, Osmon DR (2006) Do follow-up imaging examinations provide useful prognostic information in patients with spine infection? Clin Infect Dis 43:172–179PubMedCrossRefGoogle Scholar
  96. 96.
    Krodel A, Kruger A, Lohscheidt K, Pfahler M, Refior HJ (1999) Anterior debridement, fusion, and extrafocal stabilization in the treatment of osteomyelitis of the spine. J Spinal Disord 12:17–26PubMedGoogle Scholar
  97. 97.
    Krogsgaard MR, Wagn P, Bengtsson J (1998) Epidemiology of acute vertebral osteomyelitis in Denmark: 137 cases in Denmark 1978–1982, compared to cases reported to the National Patient Register 1991–1993. Acta Orthop Scand 69:513–517PubMedCrossRefGoogle Scholar
  98. 98.
    Kuklo TR, Potter BK, Bell RS, Moquin RR, Rosner MK (2006) Single-stage treatment of pyogenic spinal infection with titanium mesh cages. J Spinal Disord Tech 19:376–382PubMedCrossRefGoogle Scholar
  99. 99.
    Kulowski J (1936) Pyogenic osteomyelitis of the spine: an analysis and discussion of 102 cases. J Bone Joint Surg Am 18:22Google Scholar
  100. 100.
    Lam KS, Webb JK (2004) Discitis. Hosp Med 65:280–286PubMedCrossRefGoogle Scholar
  101. 101.
    Lazzarini L, Lipsky BA, Mader JT (2005) Antibiotic treatment of osteomyelitis: what have we learned from 30 years of clinical trials? Int J Infect Dis 9:127–138PubMedCrossRefGoogle Scholar
  102. 102.
    Le Moal G, Roblot F, Paccalin M, Sosner P, Burucoa C, Roblot P, Becq-Giraudon B (2002) Clinical and laboratory characteristics of infective endocarditis when associated with spondylodiscitis. Eur J Clin Microbiol Infect Dis 21:671–675PubMedCrossRefGoogle Scholar
  103. 103.
    Ledermann HP, Schweitzer ME, Morrison WB, Carrino JA (2003) MR imaging findings in spinal infections: rules or myths? Radiology 228:506–514PubMedCrossRefGoogle Scholar
  104. 104.
    Legrand E, Flipo RM, Guggenbuhl P, Masson C, Maillefert JF, Soubrier M, Noel E, Saraux A, Di Fazano CS, Sibilia J, Goupille P, Chevalie X, Cantagrel A, Conrozier T, Ravaud P, Liote F (2001) Management of nontuberculous infectious discitis. treatments used in 110 patients admitted to 12 teaching hospitals in France. Joint Bone Spine 68:504–509PubMedCrossRefGoogle Scholar
  105. 105.
    Lerner RK, Esterhai JL Jr, Polomono RC, Cheatle MC, Heppenstall RB, Brighton CT (1991) Psychosocial, functional, and quality of life assessment of patients with posttraumatic fracture nonunion, chronic refractory osteomyelitis, and lower extremity amputation. Arch Phys Med Rehabil 72:122–126PubMedGoogle Scholar
  106. 106.
    Lew DP, Waldvogel FA (1995) Quinolones and osteomyelitis: state-of-the-art. Drugs 49(Suppl 2):100–111PubMedCrossRefGoogle Scholar
  107. 107.
    Lew DP, Waldvogel FA (2004) Osteomyelitis. Lancet 364:369–379CrossRefGoogle Scholar
  108. 108.
    Light RW, Dunham TR (1974) Vertebral osteomyelitis due to Pseudomonas in the occasional heroin user. JAMA 228:1272PubMedCrossRefGoogle Scholar
  109. 109.
    Liljenqvist U, Lerner T, Bullmann V, Hackenberg L, Halm H, Winkelmann W (2003) Titanium cages in the surgical treatment of severe vertebral osteomyelitis. Eur Spine J 12:606–612PubMedPubMedCentralCrossRefGoogle Scholar
  110. 110.
    Linhardt O, Matussek J, Refior HJ, Krodel A (2007) Long-term results of ventro-dorsal versus ventral instrumentation fusion in the treatment of spondylitis. Int Orthop 31:113–119PubMedCrossRefGoogle Scholar
  111. 111.
    Luzzati R, Giacomazzi D, Danzi MC, Tacconi L, Concia E, Vento S (2009) Diagnosis, management and outcome of clinically- suspected spinal infection. J Infect 58:259–265PubMedCrossRefGoogle Scholar
  112. 112.
    Malincarne L, Ghebregzabher M, Moretti MV, Egidi AM, Canovari B, Tavolieri G, Francisci D, Cerulli G, Baldelli F (2006) Penetration of moxifloxacin into bone in patients undergoing total knee arthroplasty. J Antimicrob Chemother 57:950–954PubMedCrossRefGoogle Scholar
  113. 113.
    Markus HS (1989) Haematogenous osteomyelitis in the adult: a clinical and epidemiological study. Q J Med 71:521–527PubMedGoogle Scholar
  114. 114.
    Masuda T, Miyamoto K, Hosoe H, Shimizu K (2011) Comparative study on the efficacy of two-staged (posterior followed by anterior) surgical treatment using spinal instrumentation on pyogenic and tuberculotic spondylitis. Arch Orthop Trauma Surg 131:765–772PubMedCrossRefGoogle Scholar
  115. 115.
    Matsui H, Hirano N, Sakaguchi Y (1998) Vertebral osteomyelitis: an analysis of 38 surgically treated cases. Eur Spine J 7:50–54PubMedPubMedCentralCrossRefGoogle Scholar
  116. 116.
    McHenry MC, Duchesneau PM, Keys TF, Rehm SJ, Boumphrey FR (1988) Vertebral osteomyelitis presenting as spinal compression fracture. Six patients with underlying osteoporosis. Arch Intern Med 148:417–423PubMedCrossRefGoogle Scholar
  117. 117.
    McHenry MC, Easley KA, Locker GA (2002) Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Cleveland-area hospitals. Clin Infect Dis 34:1342–1350PubMedCrossRefGoogle Scholar
  118. 118.
    McKinnon PS, Davis SL (2004) Pharmacokinetic and pharmacodynamic issues in the treatment of bacterial infectious diseases. Eur J Clin Microbiol Infect Dis 23:271–288PubMedCrossRefGoogle Scholar
  119. 119.
    Messer HD, Litvinoff J (1976) Pyogenic cervical osteomyelitis. Chondro-osteomyelitis of the cervical spine frequently associated with parenteral drug use. Arch Neurol 33:571–576PubMedCrossRefGoogle Scholar
  120. 120.
    Michel SC, Pfirrmann CW, Boos N, Hodler J (2006) CT-guided core biopsy of subchondral bone and intervertebral space in suspected spondylodiskitis. AJR Am J Roentgenol 186:977–980PubMedCrossRefGoogle Scholar
  121. 121.
    Modic MT, Feiglin DH, Piraino DW, Boumphrey F, Weinstein MA, Duchesneau PM, Rehm S (1985) Vertebral osteomyelitis: assessment using MR. Radiology 157:157–166PubMedCrossRefGoogle Scholar
  122. 122.
    Mondorf Y, Gaab MR, Oertel JM (2009) PEEK cage cervical ventral fusion in spondylodiscitis. Acta Neurochir (Wien) 151:1537–1541CrossRefGoogle Scholar
  123. 123.
    Mylona E, Samarkos M, Kakalou E, Fanourgiakis P, Skoutelis A (2009) Pyogenic vertebral osteomyelitis: a systematic review of clinical characteristics. Semin Arthritis Rheum 39:10–17PubMedCrossRefGoogle Scholar
  124. 124.
    Nagashima H, Morio Y, Nishi T, Hagino H, Teshima R (2002) Spontaneous fusion of isthmic spondylolisthesis after discitis: a case report. Clin Orthop Relat Res 403:104–107CrossRefGoogle Scholar
  125. 125.
    Nagashima H, Yamane K, Nishi T, Nanjo Y, Teshima R (2010) Recent trends in spinal infections: retrospective analysis of patients treated during the past 50 years. Int Orthop 34:395–399PubMedCrossRefGoogle Scholar
  126. 126.
    Nagashima H, Nanjo Y, Tanida A, Dokai T, Teshima R (2012) Clinical features of spinal infection in individuals older than eighty years. Int Orthop 36:1229–1234PubMedCrossRefGoogle Scholar
  127. 127.
    Nagashima H, Nanjo Y, Tanida A, Dokai T, Yamane K, Teshima R (2013) Early surgical intervention for spinal infection in patients with malignancy requiring chemotherapy: report of two cases and review of the literature. Eur J Orthop Surg Traumatol 23(Suppl 2):S155–S158PubMedCrossRefGoogle Scholar
  128. 128.
    Nagel DA, Albright JA, Keggi KJ, Southwick WO (1965) Closer look at spinal lesions. Open biopsy of vertebral lesions. JAMA 191:975–978PubMedCrossRefGoogle Scholar
  129. 129.
    Nather A, David V, Hee HT, Thambiah J (2005) Pyogenic vertebral osteomyelitis: a review of 14 cases. J Orthop Surg (Hong Kong) 13:240–244CrossRefGoogle Scholar
  130. 130.
    Nicolle LE (1994) Urinary tract infection in the elderly. J Antimicrob Chemother 33(Suppl A):99–109PubMedCrossRefGoogle Scholar
  131. 131.
    Nicolle LE (1994) Prevention and treatment of urinary catheter-related infections in older patients. Drugs Aging 4:379–391PubMedCrossRefGoogle Scholar
  132. 132.
    Nicolle LE (1997) Asymptomatic bacteriuria in the elderly. Infect Dis Clin North Am 11:647–662PubMedCrossRefGoogle Scholar
  133. 133.
    Nicolle LE, Mayhew WJ, Bryan L (1987) Prospective randomized comparison of therapy and no therapy for asymptomatic bacteriuria in institutionalized elderly women. Am J Med 83:27–33PubMedCrossRefGoogle Scholar
  134. 134.
    Nicolle LE, Muir P, Harding GK, Norris M (1988) Localization of urinary tract infection in elderly, institutionalized women with asymptomatic bacteriuria. J Infect Dis 157:65–70PubMedCrossRefGoogle Scholar
  135. 135.
    Niederman MS, Mandell LA, Anzueto A, Bass JB, Broughton WA, Campbell GD, Dean N, File T, Fine MJ, Gross PA, Martinez F, Marrie TJ, Plouffe JF, Ramirez J, Sarosi GA, Torres A, Wilson R, Yu VL (2001) Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med 163:1730–1754PubMedCrossRefGoogle Scholar
  136. 136.
    Nolla JM, Ariza J, Gomez-Vaquero C, Fiter J, Bermejo J, Valverde J, Escofet DR, Gudiol F (2002) Spontaneous pyogenic vertebral osteomyelitis in nondrug users. Semin Arthritis Rheum 31:271–278PubMedCrossRefGoogle Scholar
  137. 137.
    O’Daly BJ, Morris SF, O’Rourke SK (2008) Long-term functional outcome in pyogenic spinal infection. Spine (Phila Pa 1976) 33:E246–E253CrossRefGoogle Scholar
  138. 138.
    Obana WG, Rosenblum ML (1992) Nonoperative treatment of neurosurgical infections. Neurosurg Clin N Am 3:359–373PubMedGoogle Scholar
  139. 139.
    Oga M, Arizono T, Takasita M, Sugioka Y (1993) Evaluation of the risk of instrumentation as a foreign body in spinal tuberculosis. Clinical and biologic study. Spine (Phila Pa 1976) 18:1890–1894CrossRefGoogle Scholar
  140. 140.
    Olk DG, Hamill RJ, Proctor RA (1987) Haemophilus parainfluenzae vertebral osteomyelitis. Am J Med Sci 294:114–116PubMedCrossRefGoogle Scholar
  141. 141.
    Osenbach RK, Hitchon PW, Menezes AH (1990) Diagnosis and management of pyogenic vertebral osteomyelitis in adults. Surg Neurol 33:266–275PubMedCrossRefGoogle Scholar
  142. 142.
    Park KH, Chong YP, Kim SH, Lee SO, Choi SH, Lee MS, Jeong JY, Woo JH, Kim YS (2013) Clinical characteristics and therapeutic outcomes of hematogenous vertebral osteomyelitis caused by methicillin-resistant Staphylococcus aureus. J Infect 67:556–564PubMedCrossRefGoogle Scholar
  143. 143.
    Patzakis MJ, Rao S, Wilkins J, Moore TM, Harvey PJ (1991) Analysis of 61 cases of vertebral osteomyelitis. Clin Orthop Relat Res 264:178–183Google Scholar
  144. 144.
    Pee YH, Park JD, Choi YG, Lee SH (2008) Anterior debridement and fusion followed by posterior pedicle screw fixation in pyogenic spondylodiscitis: autologous iliac bone strut versus cage. J Neurosurg Spine 8:405–412PubMedCrossRefGoogle Scholar
  145. 145.
    Perronne C, Saba J, Behloul Z, Salmon-Ceron D, Leport C, Vilde JL, Kahn MF (1994) Pyogenic and tuberculous spondylodiskitis (vertebral osteomyelitis) in 80 adult patients. Clin Infect Dis 19:746–750PubMedCrossRefGoogle Scholar
  146. 146.
    Pigrau C, Almirante B, Flores X, Falco V, Rodriguez D, Gasser I, Villanueva C, Pahissa A (2005) Spontaneous pyogenic vertebral osteomyelitis and endocarditis: incidence, risk factors, and outcome. Am J Med 118:1287PubMedCrossRefGoogle Scholar
  147. 147.
    Priest DH, Peacock JE Jr (2005) Hematogenous vertebral osteomyelitis due to Staphylococcus aureus in the adult: clinical features and therapeutic outcomes. South Med J 98:854–862PubMedCrossRefGoogle Scholar
  148. 148.
    Propst-Proctor SL, Dillingham MF, McDougall IR, Goodwin D (1982) The white blood cell scan in orthopedics. Clin Orthop Relat Res 168:157–165Google Scholar
  149. 149.
    Quinn SF, Murray W, Clark RA, Cochran C (1988) MR imaging of chronic osteomyelitis. J Comput Assist Tomogr 12:113–117PubMedCrossRefGoogle Scholar
  150. 150.
    Rath SA, Neff U, Schneider O, Richter HP (1996) Neurosurgical management of thoracic and lumbar vertebral osteomyelitis and discitis in adults: a review of 43 consecutive surgically treated patients. Neurosurgery 38:926–933PubMedCrossRefGoogle Scholar
  151. 151.
    Rissing JP (1997) Antimicrobial therapy for chronic osteomyelitis in adults: role of the quinolones. Clin Infect Dis 25:1327–1333PubMedCrossRefGoogle Scholar
  152. 152.
    Roblot F, Besnier JM, Juhel L, Vidal C, Ragot S, Bastides F, Le Moal G, Godet C, Mulleman D, Azais I, Becq-Giraudon B, Choutet P (2007) Optimal duration of antibiotic therapy in vertebral osteomyelitis. Semin Arthritis Rheum 36:269–277PubMedCrossRefGoogle Scholar
  153. 153.
    Ross PM, Fleming JL (1976) Vertebral body osteomyelitis: spectrum and natural history. A retrospective analysis of 37 cases. Clin Orthop Relat Res 118:190–198Google Scholar
  154. 154.
    Ruf M, Stoltze D, Merk HR, Ames M, Harms J (2007) Treatment of vertebral osteomyelitis by radical debridement and stabilization using titanium mesh cages. Spine (Phila Pa 1976) 32:E275–E280CrossRefGoogle Scholar
  155. 155.
    Salahuddin NI, Madhavan T, Fisher EJ, Cox F, Quinn EL, Eyler WR (1973) Pseudomonas osteomyelitis. Radiologic features. Radiology 109:41–47PubMedCrossRefGoogle Scholar
  156. 156.
    Sapico FL (1996) Microbiology and antimicrobial therapy of spinal infections. Orthop Clin North Am 27:9–13PubMedGoogle Scholar
  157. 157.
    Sapico FL, Montgomerie JZ (1979) Pyogenic vertebral osteomyelitis: report of nine cases and review of the literature. Rev Infect Dis 1:754–776PubMedCrossRefGoogle Scholar
  158. 158.
    Sapico FL, Montgomerie JZ (1990) Vertebral osteomyelitis. Infect Dis Clin North Am 4:539–550PubMedGoogle Scholar
  159. 159.
    Schimmer RC, Jeanneret C, Nunley PD, Jeanneret B (2002) Osteomyelitis of the cervical spine: a potentially dramatic disease. J Spinal Disord Tech 15:110–117PubMedCrossRefGoogle Scholar
  160. 160.
    Schinkel C, Gottwald M, Andress HJ (2003) Surgical treatment of spondylodiscitis. Surg Infect (Larchmt) 4:387–391CrossRefGoogle Scholar
  161. 161.
    Schuster JM, Avellino AM, Mann FA, Girouard AA, Grady MS, Newell DW, Winn HR, Chapman JR, Mirza SK (2000) Use of structural allografts in spinal osteomyelitis: a review of 47 cases. J Neurosurg 93:8–14PubMedGoogle Scholar
  162. 162.
    Scuderi GJ, Greenberg SS, Banovac K, Martinez OV, Eismont FJ (1993) Penetration of glycopeptide antibiotics in nucleus pulposus. Spine (Phila Pa 1976) 18:2039–2042CrossRefGoogle Scholar
  163. 163.
    Silverthorn KG, Gillespie WJ (1986) Pyogenic spinal osteomyelitis: a review of 61 cases. N Z Med J 99:62–65PubMedGoogle Scholar
  164. 164.
    Smith AS, Blaser SI (1991) Infectious and inflammatory processes of the spine. Radiol Clin North Am 29:809–827PubMedGoogle Scholar
  165. 165.
    Smith AS, Weinstein MA, Mizushima A, Coughlin B, Hayden SP, Lakin MM, Lanzieri CF (1989) MR imaging characteristics of tuberculous spondylitis vs vertebral osteomyelitis. AJR Am J Roentgenol 153:399–405PubMedCrossRefGoogle Scholar
  166. 166.
    Solis Garcia del Pozo JM, Vives Soto M, Solera J (2007) Vertebral osteomyelitis: long-term disability assessment and prognostic factors. J Infect 54:129–134PubMedCrossRefGoogle Scholar
  167. 167.
    Song KH, Jeon JH, Park WB, Kim SH, Park KU, Kim NJ, Oh MD, Kim HB, Choe KW (2009) Usefulness of the whole-blood interferon-gamma release assay for diagnosis of extrapulmonary tuberculosis. Diagn Microbiol Infect Dis 63:182–187CrossRefPubMedGoogle Scholar
  168. 168.
    Stein GE (1996) Pharmacokinetics and pharmacodynamics of newer fluoroquinolones. Clin Infect Dis 23:S19–S24PubMedCrossRefGoogle Scholar
  169. 169.
    Stoker DJ, Kissin CM (1985) Percutaneous vertebral biopsy: a review of 135 cases. Clin Radiol 36:569–577PubMedCrossRefGoogle Scholar
  170. 170.
    Stone DB, Bonfiglio M (1963) Pyogenic vertebral osteomyelitis. A diagnostic pitfall for the internist. Arch Intern Med 112:491–500PubMedCrossRefGoogle Scholar
  171. 171.
    Sundararaj GD, Babu N, Amritanand R, Venkatesh K, Nithyananth M, Cherian VM, Lee VN (2007) Treatment of haematogenous pyogenic vertebral osteomyelitis by single-stage anterior debridement, grafting of the defect and posterior instrumentation. J Bone Joint Surg Br 89:1201–1205PubMedCrossRefGoogle Scholar
  172. 172.
    Syvanen J, Peltola V, Pajulo O, Ruuskanen O, Mertsola J, Helenius I (2014) Normal behavior of plasma procalcitonin in adolescents undergoing surgery for scoliosis. Scand J Surg 103:60–65PubMedCrossRefGoogle Scholar
  173. 173.
    Szypryt EP, Hardy JG, Hinton CE, Worthington BS, Mulholland RC (1988) A comparison between magnetic resonance imaging and scintigraphic bone imaging in the diagnosis of disc space infection in an animal model. Spine (Phila Pa 1976) 13:1042–1048CrossRefGoogle Scholar
  174. 174.
    Tali ET, Gultekin S (2005) Spinal infections. Eur Radiol 15:599–607PubMedCrossRefGoogle Scholar
  175. 175.
    Thompson D, Bannister P, Murphy P (1988) Vertebral osteomyelitis in the elderly. Br Med J (Clin Res Ed) 296:1309–1311CrossRefGoogle Scholar
  176. 176.
    Torda AJ, Gottlieb T, Bradbury R (1995) Pyogenic vertebral osteomyelitis: analysis of 20 cases and review. Clin Infect Dis 20:320–328PubMedCrossRefGoogle Scholar
  177. 177.
    Tsiodras S, Falagas ME (2006) Clinical assessment and medical treatment of spine infections. Clin Orthop Relat Res 444:38–50PubMedCrossRefGoogle Scholar
  178. 178.
    Visalli MA, Jacobs MR, Appelbaum PC (1996) Activity of CP 99,219 (trovafloxacin) compared with ciprofloxacin, sparfloxacin, clinafloxacin, lomefloxacin and cefuroxime against ten penicillin-susceptible and penicillin-resistant pneumococci by time-kill methodology. J Antimicrob Chemother 37:77–84PubMedCrossRefGoogle Scholar
  179. 179.
    Waldvogel FA, Papageorgiou PS (1980) Osteomyelitis: the past decade. N Engl J Med 303:360–370PubMedCrossRefGoogle Scholar
  180. 180.
    Waldvogel FA, Medoff G, Swartz MN (1970) Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects. N Engl J Med 282:198–206PubMedCrossRefGoogle Scholar
  181. 181.
    Waldvogel FA, Medoff G, Swartz MN (1970) Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects (second of three parts). N Engl J Med 282:260–266PubMedCrossRefGoogle Scholar
  182. 182.
    Walter J, Kuhn SA, Reichart R, Kalff R, Ewald C (2010) PEEK cages as a potential alternative in the treatment of cervical spondylodiscitis: a preliminary report on a patient series. Eur Spine J 19:1004–1009PubMedPubMedCentralCrossRefGoogle Scholar
  183. 183.
    Wiesseman GJ, Wood VE, Kroll LL, Linda L (1973) Pseudomonas vertebral osteomyelitis in heroin addicts. Report of five cases. J Bone Joint Surg Am 55:1416–1424PubMedCrossRefGoogle Scholar
  184. 184.
    Wiley AM, Trueta J (1959) The vascular anatomy of the spine and its relationship to pyogenic vertebral osteomyelitis. J Bone Joint Surg Br 41-b:796–809PubMedGoogle Scholar
  185. 185.
    Wisneski RJ (1991) Infectious disease of the spine. Diagnostic and treatment considerations. Orthop Clin North Am 22:491–501PubMedGoogle Scholar
  186. 186.
    Woertgen C, Rothoerl RD, Englert C, Neumann C (2006) Pyogenic spinal infections and outcome according to the 36-item short form health survey. J Neurosurg Spine 4:441–446PubMedCrossRefGoogle Scholar
  187. 187.
    Yamane K, Nagashima H, Tanishima S, Teshima R (2010) Severe rotational deformity, quadriparesis and respiratory embarrassment due to osteomyelitis at the occipito-atlantoaxial junction. J Bone Joint Surg Br 92:286–288PubMedCrossRefGoogle Scholar
  188. 188.
    Yang SC, Fu TS, Chen LH, Chen WJ, Tu YK (2008) Identifying pathogens of spondylodiscitis: percutaneous endoscopy or CT-guided biopsy. Clin Orthop Relat Res 466:3086–3092PubMedPubMedCentralCrossRefGoogle Scholar
  189. 189.
    Yoon SH, Chung SK, Kim KJ, Kim HJ, Jin YJ, Kim HB (2010) Pyogenic vertebral osteomyelitis: identification of microorganism and laboratory markers used to predict clinical outcome. Eur Spine J 19:575–582PubMedCrossRefGoogle Scholar
  190. 190.
    Yoshimoto M, Takebayashi T, Kawaguchi S, Tsuda H, Ida K, Wada T, Yamashita T (2011) Pyogenic spondylitis in the elderly: a report from Japan with the most aging society. Eur Spine J 20:649–654PubMedCrossRefGoogle Scholar
  191. 191.
    Zarrouk V, Feydy A, Salles F, Dufour V, Guigui P, Redondo A, Fantin B (2007) Imaging does not predict the clinical outcome of bacterial vertebral osteomyelitis. Rheumatology (Oxford) 46:292–295CrossRefGoogle Scholar

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© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of Orthopedic Surgery, Faculty of MedicineTottori UniversityYonagoJapan

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