Open Access

Stefan Motov, Bastian Stemmer, Phillip Krauss, Maximilian-Niklas Bonk, Christina Wolfert, Kathrin Steininger, Björn Sommer, Ehab Shiban

• Oral e-Poster Presentations - Booth 3: Spine 2 (Tumors), September 26, 2023, 4:10 PM - 4:50 PM Background: Cervical spondylodiscitis is an uncommon entity, with an incidence of 0.5 to 2.5 per 100.000 population, which is potentially extremely harmful. This type of discogenic and vertebral infection might cause a high rate of neurological impairment. Radical surgical debridement of the infected segment with fusion and intravenous antibiotic regimen remains the gold standard in most spine centers. We aimed to analyze the overall outcome in a tertiary spine center. Methods: In this study, we retrospectively included all patients suffering from cervical spondylodiscitis between 01/2017 and 05/2022, treated at the university hospital of Augsburg. Clinical and radiological parameters as well as type of implant were collected and evaluated. Descriptive statistics were performed using SPSS, and relevant correlations were examined using the t-test for independent samples and theOral e-Poster Presentations - Booth 3: Spine 2 (Tumors), September 26, 2023, 4:10 PM - 4:50 PM Background: Cervical spondylodiscitis is an uncommon entity, with an incidence of 0.5 to 2.5 per 100.000 population, which is potentially extremely harmful. This type of discogenic and vertebral infection might cause a high rate of neurological impairment. Radical surgical debridement of the infected segment with fusion and intravenous antibiotic regimen remains the gold standard in most spine centers. We aimed to analyze the overall outcome in a tertiary spine center. Methods: In this study, we retrospectively included all patients suffering from cervical spondylodiscitis between 01/2017 and 05/2022, treated at the university hospital of Augsburg. Clinical and radiological parameters as well as type of implant were collected and evaluated. Descriptive statistics were performed using SPSS, and relevant correlations were examined using the t-test for independent samples and the Chi-square test. Results: 24 patients were identified and included. 17 patients (71%) suffered from sepsis on admission, 17 patients (71%) were diagnosed with epidural abscess on primary imaging and 5 patients (21%) had more than one discitis focus in a distant spinal segment. The presence of epidural abscess was significantly associated with systemic sepsis (OR=6.2; p=0.03) and myelopathy symptoms (OR= 14.4; p=0.00). Septic status was significantly associated with the occurrence of discitis in other spine segments (p=0.02), higher CCI (p=0.03) and Clavien Dindo scores (p=0.01), as well as a longer ICU stay (p=0.04) and the occurrence of nonunion (p=0.06). The most commonly detected germ was a multisensitive staphylococcus aureus (10 patients, 42%). A total of 6 patients (25%) died after a median of 20 days despite antibiogram-accurate therapy. The follow-up data of 15 patients (63%) was available with the evidence of permanent neurological damage in 9 patients (38%). The type of osteosynthesis was not significantly associated with subsidence (p=0.13), nonunion (p=0.21) or revision surgery (p=0.20). However the extent of instrumentation correlated significantly with the rate of nonunion (p=0.05). Conclusions: Cervical spondylodiscitis presents a severe infectious disease that occurs in multimorbid elderly patients and, despite adequate surgical and antibiotic treatment, is often associated with permanent neurological damage or a fatal outcome. Implant selection did not play a decisive role for the clinical and radiological outcome in this study.…