Treatment Guideline for Patients with Native Culture-negative Pyogenic Vertebral Osteomyelitis

CONCLUSION: Among patients with negative initial nonoperative culture results, spinal decompression and abscess drainage can be used in those with substantial or aggravating neurological deficits or intractable pain caused by an abscess, while additional early spinal instrumentation can be applied upon consideration of their medical comorbidities and the presence of a psoas abscess when mechanical instability is present before or after the spinal decompression. Reasonable clinical results can be expected, regardless of the results from subsequent operative cultures. However, our study results should be replicated by other centers, and further studies that consider individual differences such as bone mineral density and include patients with previous spinal instrumentation or recurrent infection should be performed to establish a more comprehensive treatment protocol.LEVEL OF EVIDENCE: Level IV, therapeutic study.PMID:34128841 | DOI:10.1097/CORR.0000000000001866
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Source Type: research