Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review

Objective. To analyze the results of surgical treatment of chronic infectious cervical spondylitis and literature data. Material and Methods. Design: retrospective monocentric cohort study for 2017–2020. The study included medical history and clini- cal and instrumental data of 25 patients who und...

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Autores principales:	Denis G. Naumov, Sergey G. Tkach, Aleksandr Yu. Mushkin, Marina E. Makogonova
Formato:	article
Lenguaje:	EN RU
Publicado:	Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" 2021
Materias:	spondylitis cervical spine cervical spine reconstruction atlantooccipital fusion sagittal balance Surgery RD1-811
Acceso en línea:	https://doaj.org/article/5f2dae9a62754686adda6521ebee6d3b
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spelling	oai:doaj.org-article:5f2dae9a62754686adda6521ebee6d3b2021-11-23T07:04:48ZChronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review10.14531/ss2021.3.68-761810-89972313-1497https://doaj.org/article/5f2dae9a62754686adda6521ebee6d3b2021-09-01T00:00:00Zhttps://www.spinesurgery.ru/jour/article/view/1830/1826https://doaj.org/toc/1810-8997https://doaj.org/toc/2313-1497Objective. To analyze the results of surgical treatment of chronic infectious cervical spondylitis and literature data. Material and Methods. Design: retrospective monocentric cohort study for 2017–2020. The study included medical history and clini- cal and instrumental data of 25 patients who underwent 28 reconstructive surgeries on the suboccipital (n1 = 3) and subaxial (n2 = 25) spine. The average follow-up period was 1 year 2 months ± 4 months. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 22.0. Results. The effect of the duration of the therapeutic pause (p = 0.043) and the T1 slope (T1S) (p = 0.022) on the intensity of verte- brogenic pain syndrome was established. When assessing the parameters of the sagittal balance a direct relationship between the age of patients and the value of cervical sagittal vertical axis (CSVA) (p = 0.035) was revealed, while CSVA (p = 0.514) and neck tilt angle (NTA) (p = 0.617) did not significantly affect the intensity of vertebral pain syndrome. The extent of vertebral destruction did not affect either the intensity of vertebral pain (p = 0.872) or the indices of the sagittal balance: CSVA (p = 0.116), T1S (p = 0.154), and NTA (p = 0.562). A significant predictor of postoperative complications is the level of comorbidity with an index of 7 or more (p = 0.027) ac- cording to the Charlson scale. Conclusion. The leading predictors of complications of surgical treatment of cervical infectious spondylitis are the Charlson comorbidity index (7 points or more) and the variant of anterior reconstruction (the use of a blocked extraspinal plate). The factors influencing the intensity of vertebrogenic pain syndrome in this pathology are the duration of the therapeutic pause and the magnitude of T1S compen- sation. Anterior reconstruction of the cervical spine in the presence of infectious spondylitis provides a correction of the sagittal balance parameters, with the possibility of long-term maintaining the achieved values.Denis G. NaumovSergey G. TkachAleksandr Yu. MushkinMarina E. MakogonovaMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"articlespondylitiscervical spinecervical spine reconstructionatlantooccipital fusionsagittal balanceSurgeryRD1-811ENRUХирургия позвоночника, Vol 18, Iss 3, Pp 68-76 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	spondylitis cervical spine cervical spine reconstruction atlantooccipital fusion sagittal balance Surgery RD1-811
spellingShingle	spondylitis cervical spine cervical spine reconstruction atlantooccipital fusion sagittal balance Surgery RD1-811 Denis G. Naumov Sergey G. Tkach Aleksandr Yu. Mushkin Marina E. Makogonova Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review
description	Objective. To analyze the results of surgical treatment of chronic infectious cervical spondylitis and literature data. Material and Methods. Design: retrospective monocentric cohort study for 2017–2020. The study included medical history and clini- cal and instrumental data of 25 patients who underwent 28 reconstructive surgeries on the suboccipital (n1 = 3) and subaxial (n2 = 25) spine. The average follow-up period was 1 year 2 months ± 4 months. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 22.0. Results. The effect of the duration of the therapeutic pause (p = 0.043) and the T1 slope (T1S) (p = 0.022) on the intensity of verte- brogenic pain syndrome was established. When assessing the parameters of the sagittal balance a direct relationship between the age of patients and the value of cervical sagittal vertical axis (CSVA) (p = 0.035) was revealed, while CSVA (p = 0.514) and neck tilt angle (NTA) (p = 0.617) did not significantly affect the intensity of vertebral pain syndrome. The extent of vertebral destruction did not affect either the intensity of vertebral pain (p = 0.872) or the indices of the sagittal balance: CSVA (p = 0.116), T1S (p = 0.154), and NTA (p = 0.562). A significant predictor of postoperative complications is the level of comorbidity with an index of 7 or more (p = 0.027) ac- cording to the Charlson scale. Conclusion. The leading predictors of complications of surgical treatment of cervical infectious spondylitis are the Charlson comorbidity index (7 points or more) and the variant of anterior reconstruction (the use of a blocked extraspinal plate). The factors influencing the intensity of vertebrogenic pain syndrome in this pathology are the duration of the therapeutic pause and the magnitude of T1S compen- sation. Anterior reconstruction of the cervical spine in the presence of infectious spondylitis provides a correction of the sagittal balance parameters, with the possibility of long-term maintaining the achieved values.
format	article
author	Denis G. Naumov Sergey G. Tkach Aleksandr Yu. Mushkin Marina E. Makogonova
author_facet	Denis G. Naumov Sergey G. Tkach Aleksandr Yu. Mushkin Marina E. Makogonova
author_sort	Denis G. Naumov
title	Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review
title_short	Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review
title_full	Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review
title_fullStr	Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review
title_full_unstemmed	Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review
title_sort	chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review
publisher	Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
publishDate	2021
url	https://doaj.org/article/5f2dae9a62754686adda6521ebee6d3b
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Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review

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