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Bacterial Infections of the Spine

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Neurological Complications of Infectious Diseases

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Spine infections are a group of heterogenous clinical entities resulting from hematogenous seeding or direct inoculation of microrganisms into the various anatomical elements of the spinal column. They encompass discitis, spondylodiscitis, septic facet joints and epidural abscesses. An unacceptably long diagnostic delay remains a major challenge in spine infections, despite significant advancement in imaging and therapeutic modalities. C-reactive protein is a helpful marker in shortening the diagnostic delay. Empiric antimicrobial therapy should be withheld in hemodynamically stable patients without major neurological deficits. The proportion of spine infections managed conservatively, with antimicrobial agents only, is on the rise. Clear indications for surgery include neurological deficits caused by compression of the spinal cord and mechanical instability. Though mortality rates have improved, it remains a clinical entity with significant long-term morbidity.

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References

  1. Raj PP. Intervertebral disc: anatomy-physiology-pathophysiology-treatment. Pain Pract. 2008;8(1):18–44.

    Article  PubMed  Google Scholar 

  2. Nixon GW. Hematogenous osteomyelitis of metaphyseal-equivalent locations. AJR Am J Roentgenol. 1978;130(1):123–9.

    Article  CAS  PubMed  Google Scholar 

  3. Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng. 2011;133(7):071010.

    Article  PubMed  Google Scholar 

  4. Parkin IG, Harrison GR. The topographical anatomy of the lumbar epidural space. J Anat. 1985;141:211–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Kehrer M, Pedersen C, Jensen TG, Lassen AT. Increasing incidence of pyogenic spondylodiscitis: a 14-year population-based study. J Infect. 2014;68(4):313–20.

    Article  PubMed  Google Scholar 

  6. Lora-Tamayo J, Euba G, Narvaez JA, Murillo O, Verdaguer R, Sobrino B, et al. Changing trends in the epidemiology of pyogenic vertebral osteomyelitis: the impact of cases with no microbiologic diagnosis. Semin Arthritis Rheum. 2011;41(2):247–55.

    Article  PubMed  Google Scholar 

  7. Akiyama T, Chikuda H, Yasunaga H, Horiguchi H, Fushimi K, Saita K. Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database. BMJ Open. 2013;3(3):e002412.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Brummerstedt M, Bangstrup M, Barfod TS. High mortality from pyogenic vertebral osteomyelitis: a retrospective cohort study. Spinal Cord Ser Cases. 2018;4:59.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Issa K, Diebo BG, Faloon M, Naziri Q, Pourtaheri S, Paulino CB, et al. The epidemiology of vertebral osteomyelitis in the United States from 1998 to 2013. Clin Spine Surg. 2018;31(2):E102–E8.

    Article  PubMed  Google Scholar 

  10. McHenry MC, Easley KA, Locker GA. Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Cleveland-area hospitals. Clin Infect Dis. 2002;34(10):1342–50.

    Article  PubMed  Google Scholar 

  11. Hadjipavlou AG, Mader JT, Necessary JT, Muffoletto AJ. Hematogenous pyogenic spinal infections and their surgical management. Spine (Phila Pa 1976). 2000;25(13):1668–79.

    Article  CAS  Google Scholar 

  12. Carragee EJ. Pyogenic vertebral osteomyelitis. J Bone Joint Surg Am. 1997;79(6):874–80.

    Article  CAS  PubMed  Google Scholar 

  13. Artenstein AW, Friderici J, Holers A, Lewis D, Fitzgerald J, Visintainer P. Spinal epidural abscess in adults: a 10-year clinical experience at a tertiary care academic medical center. Open Forum Infect Dis. 2016;3(4):ofw191.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Aguilar-Company J, Pigrau C, Fernandez-Hidalgo N, Rodriguez-Pardo D, Falco V, Lung M, et al. Native vertebral osteomyelitis in aged patients: distinctive features. An observational cohort study. Infection. 2018;46(5):679–86.

    Article  PubMed  Google Scholar 

  15. Gupta A, Kowalski TJ, Osmon DR, Enzler M, Steckelberg JM, Huddleston PM, et al. Long-term outcome of pyogenic vertebral osteomyelitis: a cohort study of 260 patients. Open Forum Infect Dis. 2014;1(3):ofu107.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kim SD, Melikian R, Ju KL, Zurakowski D, Wood KB, Bono CM, et al. Independent predictors of failure of nonoperative management of spinal epidural abscesses. Spine J. 2014;14(8):1673–9.

    Article  PubMed  Google Scholar 

  17. Nolla JM, Ariza J, Gomez-Vaquero C, Fiter J, Bermejo J, Valverde J, et al. Spontaneous pyogenic vertebral osteomyelitis in nondrug users. Semin Arthritis Rheum. 2002;31(4):271–8.

    Article  PubMed  Google Scholar 

  18. Murillo O, Grau I, Gomez-Junyent J, Cabrera C, Ribera A, Tubau F, et al. Endocarditis associated with vertebral osteomyelitis and septic arthritis of the axial skeleton. Infection. 2018;46(2):245–51.

    Article  PubMed  Google Scholar 

  19. Bucher E, Trampuz A, Donati L, Zimmerli W. Spondylodiscitis associated with bacteraemia due to coagulase-negative staphylococci. Eur J Clin Microbiol Infect Dis. 2000;19(2):118–20.

    Article  CAS  PubMed  Google Scholar 

  20. Khan IA, Vaccaro AR, Zlotolow DA. Management of vertebral diskitis and osteomyelitis. Orthopedics. 1999;22(8):758–65.

    CAS  PubMed  Google Scholar 

  21. Gasbarrini AL, Bertoldi E, Mazzetti M, Fini L, Terzi S, Gonella F, et al. Clinical features, diagnostic and therapeutic approaches to haematogenous vertebral osteomyelitis. Eur Rev Med Pharmacol Sci. 2005;9(1):53–66.

    CAS  PubMed  Google Scholar 

  22. Loibl M, Stoyanov L, Doenitz C, Brawanski A, Wiggermann P, Krutsch W, et al. Outcome-related co-factors in 105 cases of vertebral osteomyelitis in a tertiary care hospital. Infection. 2014;42(3):503–10.

    Article  CAS  PubMed  Google Scholar 

  23. Yang H, Shah AA, Nelson SB, Schwab JH. Fungal spinal epidural abscess: a case series of nine patients. Spine J. 2019;19(3):516–22.

    Article  PubMed  Google Scholar 

  24. Hadjipavlou AG, Berguist S, Chen J, Necessary JT, Muffoletto AJ. Vertebral osteomyelitis. Curr Treat Options Infect Dis. 2000;2:226–37.

    Google Scholar 

  25. Chelsom J, Solberg CO. Vertebral osteomyelitis at a Norwegian University Hospital 1987–97: clinical features, laboratory findings and outcome. Scand J Infect Dis. 1998;30(2):147–51.

    Article  CAS  PubMed  Google Scholar 

  26. Priest DH, Peacock JE Jr. Hematogenous vertebral osteomyelitis due to Staphylococcus aureus in the adult: clinical features and therapeutic outcomes. South Med J. 2005;98(9):854–62.

    Article  PubMed  Google Scholar 

  27. Bateman JL, Pevzner MM. Spinal osteomyelitis: a review of 10 years’ experience. Orthopedics. 1995;18(6):561–5.

    CAS  PubMed  Google Scholar 

  28. Luney M, Adiamah A, Pearson L. Thoracic spondylodiscitis presenting as abdominal pain. BMJ Case Rep. 2016;2016

    Google Scholar 

  29. Ghaly G, Espeso A, Fish B. Idiopathic cervical osteomyelitis presenting as dysphagia. J Surg Case Rep. 2010;2010(3):6.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Muffoletto AJ, Ketonen LM, Mader JT, Crow WN, Hadjipavlou AG. Hematogenous pyogenic facet joint infection. Spine (Phila Pa 1976). 2001;26(14):1570–6.

    Article  CAS  Google Scholar 

  31. Jensen AG, Espersen F, Skinhoj P, Rosdahl VT, Frimodt-Moller N. Increasing frequency of vertebral osteomyelitis following Staphylococcus aureus bacteraemia in Denmark 1980–1990. J Infect. 1997;34(2):113–8.

    Article  CAS  PubMed  Google Scholar 

  32. Hopkinson N, Stevenson J, Benjamin S. A case ascertainment study of septic discitis: clinical, microbiological and radiological features. QJM. 2001;94(9):465–70.

    Article  CAS  PubMed  Google Scholar 

  33. Legrand E, Flipo RM, Guggenbuhl P, Masson C, Maillefert JF, Soubrier M, et al. Management of nontuberculous infectious discitis. Treatments used in 110 patients admitted to 12 teaching hospitals in France. Joint Bone Spine. 2001;68(6):504–9.

    Article  CAS  PubMed  Google Scholar 

  34. Colmenero JD, Jimenez-Mejias ME, Sanchez-Lora FJ, Reguera JM, Palomino-Nicas J, Martos F, et al. Pyogenic, tuberculous, and brucellar vertebral osteomyelitis: a descriptive and comparative study of 219 cases. Ann Rheum Dis. 1997;56(12):709–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Siemionow K, Steinmetz M, Bell G, Ilaslan H, McLain RF. Identifying serious causes of back pain: cancer, infection, fracture. Cleve Clin J Med. 2008;75(8):557–66.

    Article  PubMed  Google Scholar 

  36. Jean M, Irisson JO, Gras G, Bouchand F, Simo D, Duran C, et al. Diagnostic delay of pyogenic vertebral osteomyelitis and its associated factors. Scand J Rheumatol. 2017;46(1):64–8.

    Article  CAS  PubMed  Google Scholar 

  37. Dagirmanjian A, Schils J, McHenry M, Modic MT. MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol. 1996;167(6):1539–43.

    Article  CAS  PubMed  Google Scholar 

  38. Dunbar JA, Sandoe JA, Rao AS, Crimmins DW, Baig W, Rankine JJ. The MRI appearances of early vertebral osteomyelitis and discitis. Clin Radiol. 2010;65(12):974–81.

    Article  CAS  PubMed  Google Scholar 

  39. Diehn FE. Imaging of spine infection. Radiol Clin N Am. 2012;50(4):777–98.

    Article  PubMed  Google Scholar 

  40. Ledermann HP, Schweitzer ME, Morrison WB, Carrino JA. MR imaging findings in spinal infections: rules or myths? Radiology. 2003;228(2):506–14.

    Article  PubMed  Google Scholar 

  41. Parkinson JF, Sekhon LH. Spinal epidural abscess: appearance on magnetic resonance imaging as a guide to surgical management. Report of five cases. Neurosurg Focus. 2004;17(6):E12.

    Article  PubMed  Google Scholar 

  42. Suppiah S, Meng Y, Fehlings MG, Massicotte EM, Yee A, Shamji MF. How best to manage the spinal epidural abscess? A current systematic review. World Neurosurg. 2016;93:20–8.

    Article  PubMed  Google Scholar 

  43. Gerstein N. Spinal epidural abscess. N Engl J Med. 2007;356(6):638; author reply -9.

    Article  CAS  PubMed  Google Scholar 

  44. Love C, Palestro CJ. Nuclear medicine imaging of bone infections. Clin Radiol. 2016;71(7):632–46.

    Article  CAS  PubMed  Google Scholar 

  45. Ohtori S, Suzuki M, Koshi T, Yamashita M, Yamauchi K, Inoue G, et al. 18F-fluorodeoxyglucose-PET for patients with suspected spondylitis showing Modic change. Spine (Phila Pa 1976). 2010;35(26):E1599–603.

    Article  Google Scholar 

  46. Prodi E, Grassi R, Iacobellis F, Cianfoni A. Imaging in spondylodiskitis. Magn Reson Imaging Clin N Am. 2016;24(3):581–600.

    Article  PubMed  Google Scholar 

  47. Prodromou ML, Ziakas PD, Poulou LS, Karsaliakos P, Thanos L, Mylonakis E. FDG PET is a robust tool for the diagnosis of spondylodiscitis: a meta-analysis of diagnostic data. Clin Nucl Med. 2014;39(4):330–5.

    Article  PubMed  Google Scholar 

  48. Smids C, Kouijzer IJ, Vos FJ, Sprong T, Hosman AJ, de Rooy JW, et al. A comparison of the diagnostic value of MRI and (18)F-FDG-PET/CT in suspected spondylodiscitis. Infection. 2017;45(1):41–9.

    Article  PubMed  Google Scholar 

  49. Tali ET, Gultekin S. Spinal infections. Eur Radiol. 2005;15(3):599–607.

    Article  PubMed  Google Scholar 

  50. Andre V, Pot-Vaucel M, Cozic C, Visee E, Morrier M, Varin S, et al. Septic arthritis of the facet joint. Med Mal Infect. 2015;45(6):215–21.

    Article  CAS  PubMed  Google Scholar 

  51. Narvaez J, Nolla JM, Narvaez JA, Martinez-Carnicero L, De Lama E, Gomez-Vaquero C, et al. Spontaneous pyogenic facet joint infection. Semin Arthritis Rheum. 2006;35(5):272–83.

    Article  PubMed  Google Scholar 

  52. Mylona E, Samarkos M, Kakalou E, Fanourgiakis P, Skoutelis A. Pyogenic vertebral osteomyelitis: a systematic review of clinical characteristics. Semin Arthritis Rheum. 2009;39(1):10–7.

    Article  CAS  PubMed  Google Scholar 

  53. de Lucas EM, Gonzalez Mandly A, Gutierrez A, Pellon R, Martin-Cuesta L, Izquierdo J, et al. CT-guided fine-needle aspiration in vertebral osteomyelitis: true usefulness of a common practice. Clin Rheumatol. 2009;28(3):315–20.

    Article  PubMed  Google Scholar 

  54. Kim CJ, Song KH, Park WB, Kim ES, Park SW, Kim HB, et al. Microbiologically and clinically diagnosed vertebral osteomyelitis: impact of prior antibiotic exposure. Antimicrob Agents Chemother. 2012;56(4):2122–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Rankine JJ, Barron DA, Robinson P, Millner PA, Dickson RA. Therapeutic impact of percutaneous spinal biopsy in spinal infection. Postgrad Med J. 2004;80(948):607–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK, et al. 2015 Infectious Diseases Society of America (IDSA) clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clin Infect Dis. 2015;61(6):e26–46.

    Article  PubMed  Google Scholar 

  57. Zimmerli W. Clinical practice. Vertebral osteomyelitis. N Engl J Med. 2010;362(11):1022–9.

    Article  CAS  PubMed  Google Scholar 

  58. Hong SH, Choi JY, Lee JW, Kim NR, Choi JA, Kang HS. MR imaging assessment of the spine: infection or an imitation? Radiographics. 2009;29(2):599–612.

    Article  CAS  PubMed  Google Scholar 

  59. Bridges KJ, Bullis CL, Wanchu A, Than KD. Pseudogout of the cervical and thoracic spine mimicking infection after lumbar fusion: case report. J Neurosurg Spine. 2017;27(2):145–9.

    Article  PubMed  Google Scholar 

  60. Kasalak O, Adams HJA, Jutte PC, Overbosch J, Dierckx R, Wouthuyzen-Bakker M, et al. Culture yield of repeat percutaneous image-guided biopsy after a negative initial biopsy in suspected spondylodiscitis: a systematic review. Skelet Radiol. 2018;47(10):1327–35.

    Article  Google Scholar 

  61. Gras G, Buzele R, Parienti JJ, Debiais F, Dinh A, Dupon M, et al. Microbiological diagnosis of vertebral osteomyelitis: relevance of second percutaneous biopsy following initial negative biopsy and limited yield of post-biopsy blood cultures. Eur J Clin Microbiol Infect Dis. 2014;33(3):371–5.

    Article  CAS  PubMed  Google Scholar 

  62. Fuursted K, Arpi M, Lindblad BE, Pedersen LN. Broad-range PCR as a supplement to culture for detection of bacterial pathogens in patients with a clinically diagnosed spinal infection. Scand J Infect Dis. 2008;40(10):772–7.

    Article  CAS  PubMed  Google Scholar 

  63. Fenollar F, Roux V, Stein A, Drancourt M, Raoult D. Analysis of 525 samples to determine the usefulness of PCR amplification and sequencing of the 16S rRNA gene for diagnosis of bone and joint infections. J Clin Microbiol. 2006;44(3):1018–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Bernard L, Dinh A, Ghout I, Simo D, Zeller V, Issartel B, et al. Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial. Lancet. 2015;385(9971):875–82.

    Article  CAS  PubMed  Google Scholar 

  65. Park KH, Cho OH, Lee JH, Park JS, Ryu KN, Park SY, et al. Optimal duration of antibiotic therapy in patients with hematogenous vertebral osteomyelitis at low risk and high risk of recurrence. Clin Infect Dis. 2016;62(10):1262–9.

    Article  CAS  PubMed  Google Scholar 

  66. Lam KS, Webb JK. Discitis. Hosp Med. 2004;65(5):280–6.

    Article  PubMed  Google Scholar 

  67. Kowalski TJ, Berbari EF, Huddleston PM, Steckelberg JM, Osmon DR. Do follow-up imaging examinations provide useful prognostic information in patients with spine infection? Clin Infect Dis. 2006;43(2):172–9.

    Article  PubMed  Google Scholar 

  68. Heusner AP. Nontuberculous spinal epidural infections. N Engl J Med. 1948;239(23):845–54.

    Article  CAS  PubMed  Google Scholar 

  69. Curry WT Jr, Hoh BL, Amin-Hanjani S, Eskandar EN. Spinal epidural abscess: clinical presentation, management, and outcome. Surg Neurol. 2005;63(4):364–71; discussion 71.

    Article  PubMed  Google Scholar 

  70. Butler JS, Shelly MJ, Timlin M, Powderly WG, O’Byrne JM. Nontuberculous pyogenic spinal infection in adults: a 12-year experience from a tertiary referral center. Spine (Phila Pa 1976). 2006;31(23):2695–700.

    Article  Google Scholar 

  71. Tuchman A, Pham M, Hsieh PC. The indications and timing for operative management of spinal epidural abscess: literature review and treatment algorithm. Neurosurg Focus. 2014;37(2):E8.

    Google Scholar 

  72. Patel AR, Alton TB, Bransford RJ, Lee MJ, Bellabarba CB, Chapman JR. Spinal epidural abscesses: risk factors, medical versus surgical management, a retrospective review of 128 cases. Spine J. 2014;14(2):326–30.

    Article  PubMed  Google Scholar 

  73. Stratton A, Gustafson K, Thomas K, James MT. Incidence and risk factors for failed medical management of spinal epidural abscess: a systematic review and meta-analysis. J Neurosurg Spine. 2017;26(1):81–9.

    Article  PubMed  Google Scholar 

  74. Shah AA, Ogink PT, Nelson SB, Harris MB, Schwab JH. Nonoperative management of spinal epidural abscess: development of a predictive algorithm for failure. J Bone Joint Surg Am. 2018;100(7):546–55.

    Article  PubMed  Google Scholar 

  75. Lyu RK, Chen CJ, Tang LM, Chen ST. Spinal epidural abscess successfully treated with percutaneous, computed tomography-guided, needle aspiration and parenteral antibiotic therapy: case report and review of the literature. Neurosurgery. 2002;51(2):509–12; discussion 12.

    Article  PubMed  Google Scholar 

  76. Rust TM, Kohan S, Steel T, Lonergan R. CT guided aspiration of a cervical spinal epidural abscess. J Clin Neurosci. 2005;12(4):453–6.

    Article  CAS  PubMed  Google Scholar 

  77. Ran B, Chen X, Zhong Q, Fu M, Wei J. CT-guided minimally invasive treatment for an extensive spinal epidural abscess: a case report and literature review. Eur Spine J. 2018;27(Suppl 3):380–5.

    Article  PubMed  Google Scholar 

  78. Sundararaj GD, Amritanand R, Venkatesh K, Arockiaraj J. The use of titanium mesh cages in the reconstruction of anterior column defects in active spinal infections: can we rest the crest? Asian Spine J. 2011;5(3):155–61.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Rayes M, Colen CB, Bahgat DA, Higashida T, Guthikonda M, Rengachary S, et al. Safety of instrumentation in patients with spinal infection. J Neurosurg Spine. 2010;12(6):647–59.

    Article  PubMed  Google Scholar 

  80. Koptan W, Elmiligui Y, Elsharkawi M. Single stage anterior reconstruction using titanium mesh cages in neglected kyphotic tuberculous spondylodiscitis of the cervical spine. Eur Spine J. 2011;20(2):308–13.

    Article  PubMed  Google Scholar 

  81. Skaf GS, Domloj NT, Fehlings MG, Bouclaous CH, Sabbagh AS, Kanafani ZA, et al. Pyogenic spondylodiscitis: an overview. J Infect Public Health. 2010;3(1):5–16.

    Article  CAS  PubMed  Google Scholar 

  82. Arnold R, Rock C, Croft L, Gilliam BL, Morgan DJ. Factors associated with treatment failure in vertebral osteomyelitis requiring spinal instrumentation. Antimicrob Agents Chemother. 2014;58(2):880–4.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  83. Bostelmann R, Steiger HJ, Scholz AO. First report on treating spontaneous infectious spondylodiscitis of lumbar spine with posterior debridement, posterior instrumentation and an injectable calcium sulfate/hydroxyapatite composite eluting gentamicin: a case report. J Med Case Rep. 2016;10(1):349.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Sapico FL, Montgomerie JZ. Vertebral osteomyelitis. Infect Dis Clin N Am. 1990;4(3):539–50.

    CAS  Google Scholar 

  85. Grammatico L, Baron S, Rusch E, Lepage B, Surer N, Desenclos JC, et al. Epidemiology of vertebral osteomyelitis (VO) in France: analysis of hospital-discharge data 2002–2003. Epidemiol Infect. 2008;136(5):653–60.

    Article  CAS  PubMed  Google Scholar 

  86. O’Daly BJ, Morris SF, O’Rourke SK. Long-term functional outcome in pyogenic spinal infection. Spine (Phila Pa 1976). 2008;33(8):E246–53.

    Article  Google Scholar 

  87. Solis Garcia del Pozo J, Vives Soto M, Solera J. Vertebral osteomyelitis: long-term disability assessment and prognostic factors. J Infect. 2007;54(2):129–34.

    Article  PubMed  Google Scholar 

  88. Kokabu T, Takahata M, Ishiguro N, Iwasaki N. Long-term prognosis of hematogenous vertebral osteomyelitis: mortality, quality of life, and pain. J Orthop Sci. 2017;22(5):822–7.

    Article  PubMed  Google Scholar 

  89. Urrutia J, Zamora T, Campos M. Cervical pyogenic spinal infections: are they more severe diseases than infections in other vertebral locations? Eur Spine J. 2013;22(12):2815–20.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Park KH, Chong YP, Kim SH, Lee SO, Choi SH, Lee MS, et al. Clinical characteristics and therapeutic outcomes of hematogenous vertebral osteomyelitis caused by methicillin-resistant Staphylococcus aureus. J Infect. 2013;67(6):556–64.

    Article  PubMed  Google Scholar 

  91. D’Agostino C, Scorzolini L, Massetti AP, Carnevalini M, d’Ettorre G, Venditti M, et al. A seven-year prospective study on spondylodiscitis: epidemiological and microbiological features. Infection. 2010;38(2):102–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Infectious Disease, Cleveland Clinic, Cleveland, OH, USA

    Maja Babic

  2. Imaging Institute, Cleveland Clinic, Cleveland, OH, USA

    Claus Simpfendorfer

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  1. Maja Babic
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Correspondence to Maja Babic .

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Editors and Affiliations

  1. UT Health McGovern Medical School, Houston, TX, USA

    Rodrigo Hasbun, MD MPH

  2. Div of Infectious Dis, MCN A-2200, Vanderbilt University, Nashville, TN, USA

    Karen C. Bloch, MD MPH

  3. Dept of Infectious Diseases, Apt 635, Cleveland Clinic Foundation, Cleveland, OH, USA

    Adarsh Bhimraj, MD

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Babic, M., Simpfendorfer, C. (2021). Bacterial Infections of the Spine. In: Hasbun, MD MPH, R., Bloch, MD MPH, K.C., Bhimraj, MD, A. (eds) Neurological Complications of Infectious Diseases. Current Clinical Neurology. Humana, Cham. https://doi.org/10.1007/978-3-030-56084-3_13

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