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Infections of the Cervical Spine

  • Luca DenaroEmail author
  • Umile Giuseppe Longo
  • Vincenzo Denaro

Spinal infections are relatively rare, accounting for only 2–4% of all osteomyelitis infections, and are located preferentially in the thoracic and lumbar segments. Although the cervical segment is the less common spine localization, cervical spinal infections present the highest incidence of neurological involvement [6].

Recent advances in diagnosis and management — with the introduction of antibiotics and more aggressive surgery — greatly improved the prognosis of patients with cervical spinal infection [6].

Spinal infections have a highly variable outcome [6], with dramatic consequences in some patients. Mortality is estimated around 1–20%, depending on the infecting agent and the general health status of the patient. The incidence of paralysis because of direct cord involvement is up to 50%, depending on the patient population and the involved spinal segment.

Keywords

Human Immunodeficiency Virus Cervical Spine Spinal Infection Cervical Spine Surgery Transoral Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Acosta FL Jr, Chin CT, Quinones-Hinojosa A et al (2004) Diagnosis and management of adult pyogenic osteomyelitis of the cervical spine. Neurosurg Focus 17:E2PubMedCrossRefGoogle Scholar
  2. 2.
    Berney S, Opdam H, Bellomo R et al (2008) An assessment of early tracheostomy after anterior cervical stabilization in patients with acute cervical spine trauma. J Trauma 64:749–753PubMedCrossRefGoogle Scholar
  3. 3.
    Biswas D, Bible JE, Whang PG et al (2008) Sterility of C-arm fluoroscopy during spinal surgery. Spine 33:1913–1917PubMedCrossRefGoogle Scholar
  4. 4.
    Brown EM, Pople IK, de Louvois J et al (2004) Spine update: prevention of postoperative infection in patients undergoing spinal surgery. Spine 29:938–945PubMedCrossRefGoogle Scholar
  5. 5.
    Caird MS, Wills BP, Dormans JP (2006) Down syndrome in children: the role of the orthopaedic surgeon. J Am Acad Orthop Surg 14:610–619PubMedGoogle Scholar
  6. 6.
    Clarck CR (2005) The cervical spine, 4th edn. Lippincott Williams &Wilkins, PhiladelphiaGoogle Scholar
  7. 7.
    Kaibara T, Hurlbert RJ, Sutherland GR (2001) Intraoperative magnetic resonance imaging-augmented transoral resection of axial disease. Neurosurg Focus 10:E4PubMedCrossRefGoogle Scholar
  8. 8.
    Karadimas EJ, Bunger C, Lindblad BE et al (2008) Spondylodiscitis. A retrospective study of 163 patients. Acta Orthop 79:650–659PubMedCrossRefGoogle Scholar
  9. 9.
    Kauffman CP, Bono CM, Vessa PP et al (2000) Postoperative synergistic gangrene after spinal fusion. Spine 25:1729–1732PubMedCrossRefGoogle Scholar
  10. 10.
    Liebergall M, Chaimsky G, Lowe J et al (1991) Pyogenic vertebral osteomyelitis with paralysis. Prognosis and treatment. Clin Orthop Relat Res (269):142–150Google Scholar
  11. 11.
    Luck JV Jr, Logan LR, Benson DR et al (1996) Human immu-nodeficiency virus infection: complications and outcome of orthopaedic surgery. J Am Acad Orthop Surg 4:297–304PubMedGoogle Scholar
  12. 12.
    Massie JB, Heller JG, Abitbol JJ et al (1992) Postoperative posterior spinal wound infections. Clin Orthop Relat Res (284):99–108Google Scholar
  13. 13.
    Menezes AH (2008) Surgical approaches: postoperative care and complications “transoral-transpalatopharyngeal approach to the craniocervical junction” Nerv Syst 24:1187–1193CrossRefGoogle Scholar
  14. 14.
    Mik G, Gholve PA, Scher DM et al (2008) Down syndrome: orthopedic issues. Curr Opin Pediatr 20:30–36PubMedCrossRefGoogle Scholar
  15. 15.
    Orlando ER, Caroli E, Ferrante L (2003) Management of the cervical esophagus and hypofarinx perforations complicating anterior cervical spine surgery. Spine 28: E290–E295PubMedGoogle Scholar
  16. 16.
    Petsatodis G, Symeonidis PD, Karataglis D et al (2007) Multifocal Proteus mirabilis osteomyelitis requiring bilateral amputation in an HIV-positive patient. J Bone Joint Surg Br 89:249–251PubMedGoogle Scholar
  17. 17.
    Rohde V, Meyer B, Schaller C et al (1998) Spondylodiscitis after lumbar discectomy. Incidence and a proposal for prophylaxis. Spine 23:615–620PubMedCrossRefGoogle Scholar
  18. 18.
    Spitzer R, Rabinowich JY, Wybar KC (1961) A study of abnormalities of the skull, teeth and lenses in mongolism. J Can Med Assoc 84:567–572Google Scholar
  19. 19.
    Takahashi J, Shono Y, Hirabayashi H et al (2006) Usefulness of white blood cell differential for early diagnosis of surgical wound infection following spinal instrumentation surgery. Spine 31:1020–1025PubMedCrossRefGoogle Scholar
  20. 20.
    Tanner J, Parkinson H (2006) Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev (3): CD003087Google Scholar
  21. 21.
    Thelander U, Larsson S (1992) Quantitation of C-reactive protein levels and erythrocyte sedimentation rate after spinal surgery. Spine 17:400–404PubMedCrossRefGoogle Scholar
  22. 22.
    Wimmer C, Gluch H, Franzreb M et al (1998) Predisposing factors for infection in spine surgery: a survey of 850 spinal procedures. J Spinal Disord 11:124–128PubMedGoogle Scholar
  23. 23.
    Winslow C, Bode RK, Felton D et al (2002) Impact of respiratory complications on length of stay and hospital costs in acute cervical spine injury. Chest 121:1548–1554PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • Luca Denaro
    • 1
    Email author
  • Umile Giuseppe Longo
    • 2
  • Vincenzo Denaro
    • 2
  1. 1.Department of NeuroscienceUniversity of PaduaPaduaItaly
  2. 2.Department of Orthopaedic and Trauma SurgeryCampus Bio-Medico UniversityRomeItaly

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