Prolonged Bed Rest Versus Early Raising in Vertebral Osteomyelitis

Study Overview
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Brief Summary
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Infectious vertebral osteomyelitis are infectious diseases of the vertebral bone, intervertebral disc and/ or adjacent tissue. Most of cases are due to hematogenous dissemination of pathogen but direct inoculation is an aetiology after surgery. Majority of cases concern adults after 50 years and the annual incidence ranging between 0.5 and 2.4 cases per 100 000 habitants in Europe but seems to increase during last 20 years. The infectious spondylodiscitis is an important source of morbidity and mortality. The treatment is based on pathogen adapted antimicrobial therapy, which may be associated with bedrest. Surgical act is necessary when neurological complication occurs or when vertebral column instability is too important. The immobilization in bed is use to limit pain and neurological complications. However, the immobilization is based on few literature data and causes important complications especially in elderly. The of immobilization in Nancy universitity hospital changed in 2019 after institutional recommendations based on expert opinion which recommend an early verticalization of uncomplicated spondylodiscitis. The investigators aimed to evaluate the consequences of this practice change on the hospitalization duration and complication rates due to spondylodiscitis and immobilization.

Official Title
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SPONDYL'UP : Prolonged Bed Rest Versus Early Raising in Vertebral Osteomyelitis - A Restrospective, Monocenter, Before/After Practice Change Study

Conditions
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Infectious; Spondylitis

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Infectious spondylodiscitis proven by radiological exam Infectious spondylodiscitis with microbiological documentation Exclusion Criteria: Patient included in COROSIVE study Vertebral prosthetic device infection Infectious spondylodiscitis relapse

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| First group before practice change<br>Infectious spondylodiscitis when prolonged immoblization in bed was recommanded in our hospital | |
| Second group after practice change<br>Infectious spondylodiscitis when early verticalization was recommanded in our hospital | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of hospital stay | Duration between first and last day of hospitalisation in days | when the patient is discharged from hospital (up to 52 weeks) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of neurological complications | Measurement of the rate spondylodiscitis-related neurological complications in each group during hospitalisation | During hospitalisation (up to 52 weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Infectious vertebral osteomyelitis, Spondylodiscitis, Bed Rest, Early Raising, Verticalization, Immobilization