PURPOSE OF THE STUDY: Although great advances have been made in both radiological diagnosis and antibiotic therapy of microbial infections, the treatment of @entity281 remains a major clinical challenge. Many of the @entity1 affected are referred to spinal units with long delays. The general population is ageing and the number of immunocompromised @entity1 , as well as the number of operative procedures for @entity74 are increasing. The aim of our study was to evaluate the clinical presentations of @entity281 , options for their diagnosis, indications for treatment and their risk factors and the results of surgery. MATERIAL AND METHODS: The group of 112 @entity1 evaluated after the treatment of spinal infection comprised 63 @entity1 and 49 @entity1 at an average age of 59.4 years (range, 17 to 84). The average follow-up was 3.2 years (range, 6 months to 8 years). Of these, 82 @entity1 had primary @entity281 , 29 had @entity281 ,and one had an infected @entity69471 wound. Thirty-six @entity1 showed @entity51 and six were paraplegic. The diagnostic methods included FBC, CRP and EST tests, examination of blood cultures, aspirates and biopsy samples from the infected site, bone scintigraphy, MRI and CT scanning. Indications for surgery included an infection not responding to conservative treatment,with existing or impending spinal instability, and with or without @entity51 . The surgical management involved transpedicular @entity733 , wound debridement from the posterior approach and instrumented spondylodesis. Surgery which included spinal decompression with radical excision of infected tissue was augmented with posterolateral instrumented fusion and/or anterior stabilization, as indicated. RESULTS: Of the 112 @entity1 treated, seven died of uncontrollable @entity295 after surgery; the remaining 105 were followed up. Another four @entity1 died of causes unrelated to the spinal problem treated within 12 months. All @entity1 recovered except for two in whom the infection persisted, but 13 required more than one surgical procedure. One @entity1 with CSF leakage failed to heal after five interventions. The most frequently isolated infectious agents were @entity794 , Staphylococus epidermidis and @entity526 . Of the 33 @entity1 with @entity51 , 24 improved by one or two Frankel grades. The neurological status of six paraplegic @entity1 did not improve, but their functional findings did after stabilization of the spine. Clinical evaluation showed 47 (44.7 %) very good, 40 (38 %) good, eight (7.6 %) unchanged and 10 (9.5 %) poor outcomes. CONCLUSION: Early diagnosis is a prerequisite for good treatment outcomes. Clinical examination, results of laboratory tests, and scintigraphy and MRI findings play the key role. When progressing osteolysis is suspected, a CT scan is necessary. Debridement should be as radical as possible, but always in compliance with the @entity1 's health state. At an advanced @entity5 , spinal stabilization is important because it allows us to remove infected tissue. Intravenous and then oral antibiotic therapy at 2 to 4 and 6 to 12 weeks of follow-up is mandatory. The management of @entity281 is a complex process requiring good multidisciplinary cooperation.

[Surgical treatment of XXXX ].

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient', 'men'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['stage of disease'] @entity794 :: ('1280', 'Species') :: ['Staphylococus aureus'] @entity281 :: ('MESH:D007239', 'Disease') :: ['spinal infections', 'hematogenous infection', 'post-operative infection'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficit'] @entity733 :: ('MESH:D000038', 'Disease') :: ['drainage of the abscess'] @entity74 :: ('MESH:D030342', 'Disease') :: ['spinal disorders'] @entity69471 :: ('MESH:D057667', 'Disease') :: ['gun shot'] @entity526 :: ('562', 'Species') :: ['E. coli']
@entity281 :: (MESH:D007239,Disease) :: ['spinal infections']
