Osteomyelitis and Discitis of the Spine
A Guide for the Management of Infectious Etiology of the Vertebral Column and Neurological Components
- 1st Edition - November 15, 2024
- Imprint: Academic Press
- Editors: Dia R Halalmeh, Marc Moisi
- Language: English
- Paperback ISBN:9 7 8 - 0 - 4 4 3 - 1 9 1 3 3 - 6
- eBook ISBN:9 7 8 - 0 - 4 4 3 - 1 5 7 0 6 - 6
Osteomyelitis and Discitis of the Spine: A Guide for the Management of Infectious Etiology of the Vertebral Column and Neurological Components examines these spinal condition… Read more
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Request a sales quoteOsteomyelitis and Discitis of the Spine: A Guide for the Management of Infectious Etiology of the Vertebral Column and Neurological Components examines these spinal conditions and provides readers with the most appropriate management plans, including surgical treatment together with its indications. This book guides spine neurosurgeons and others when choosing the optimal surgical approach for their patients, shedding light on current advances in surgical techniques used in the management of vertebral osteomyelitis and discitis, particularly minimally invasive spine approaches.
With authors representing diverse specialties, chapters reflect current clinical and surgical practice and discuss pathophysiology and pain management and rehabilitation. The book begins with related anatomy and extends to post-management rehabilitation and pain control, including a chapter dedicated to pediatric patients and their differing causative organisms, etiology, diagnostic modalities, and pathophysiology. This reference will provide increased awareness of potential spinal infection, facilitating multidisciplinary management plans, improving patient safety and outcomes, and enabling early intervention alternatives that improve patient outcomes and long-term quality of life.
- Discusses current advances in surgical techniques used in the management of vertebral osteomyelitis and discitis, particularly minimally invasive spine approaches
- Contains detailed illustrations and color art-schematics to facilitate visualization and understanding of the surgical approach
- Features a chapter on tips and tricks to highlight various methods, along with strategies to minimize potential hazards during surgery
Neurosurgeons, spine neurosurgeons, neurologists, orthopaedic spine surgeons, infectious diseases specialists, fellows, residents
- Title of Book
- Cover image
- Title page
- Table of Contents
- Copyright
- Dedication
- Contributors
- Preface
- Chapter One. Overview of spinal anatomy
- The vertebral column
- Embryology
- Gross anatomy
- Vertebra
- Intervertebral disc
- Supporting ligaments
- Blood supply
- The intervertebral discs
- Introduction
- Development
- Structure
- Innervation and vascularity
- The paraspinal musculature
- Paraspinal muscles in the neck
- Anterior cervical muscles
- Lateral cervical muscles
- Posterior cervical muscles
- Muscles of the trunk and back
- The superficial group of muscles
- The intermediate group of muscles
- The deep or intrinsic back muscles
- Lateral and anterior groups
- Adjacent structures and organs
- The spinal cord
- Introduction
- History
- Embryology
- Macroscopic anatomy
- Coverings of the cord
- Denticulate ligaments (ligamentum denticulatum)
- Segments of the cord
- Nerve roots and their relation to the cord
- Lamination of the spinal cord gray matter
- Major ascending tracts
- Dorsal column
- Spinothalamic tract
- Spinoreticular tract
- Spinocerebellar tracts
- Spinotectal tract
- Spinoolivary tract
- Major descending tracts
- Corticospinal (pyramidal) tract
- Extrapyramidal tracts
- Blood supply of the spinal cord
- Introduction
- Arteries of the spinal cord
- Extrinsic system
- Intrinsic system
- Venous system
- Intrinsic venous system
- Extrinsic venous system
- Figure acknowledgements
- Chapter Two. Epidemiology, etiology, and pathogenesis
- Introduction
- Classification
- Pathophysiology
- Epidemiology of vertebral osteomyelitis and discitis (incidence, demographics, risk factors)
- Microbiology overview
- The role of biofilm in spinal infections
- Bacterial infections of the spine
- Staphylococcus aureus
- Other staphylococci
- Streptococci
- Enterococci
- Gram negatives and anaerobes
- Spinal tuberculosis (Mycobacterium tuberculosis)
- Introduction
- Pathogenesis
- Clinical presentation
- Special considerations
- Diagnosis
- Nontuberculous Mycobacteria
- Introduction
- Pathogenesis
- Spinal brucellosis
- Introduction
- Transmission
- Clinical features and diagnosis
- Treatment
- Fungal infections of the spinal cord
- Aspergillus spondylodiscitis
- Candida spondylodiscitis
- Endemic mycosis spondylodiscitis
- Cryptococcus spondylodiscitis
- Spinal hyalohyphomycosis (excluding Aspergillus)
- Spinal phaeohyphomycosis
- Parasitic infection of the spinal cord
- Neurocysticercosis
- Echinococcal infections of the spine
- Conclusion
- Chapter Three. Clinical, laboratory, and radiological assessment of acute and chronic spinal infections
- Introduction
- Spondylodiscitis
- General considerations
- Clinical and laboratory diagnosis
- Imaging
- Special considerations
- Spinal epidural abscess
- General considerations
- Clinical and laboratory diagnosis
- Imaging
- Special considerations
- Facet joint septic arthritis
- General considerations
- Clinical and laboratory diagnosis
- Imaging
- Special considerations
- Spinal subdural abscess
- General considerations
- Clinical and laboratory diagnosis
- Imaging
- Intramedullary spinal cord abscess
- Spinal meningitis/myelitis
- Postoperative spine
- General considerations
- Clinical and laboratory diagnosis
- Imaging
- Spondylodiscitis follow up
- Radiological follow up of spondylodiscitis by MRI
- Bone and bone marrow MRI follow up
- Soft tissue MRI followup
- Correlation between follow-up MRI findings and laboratory findings
- Other imaging modalities for spondylodiscitis follow up
- Spondylodiscitis prognosis—A radiological point of view
- Conclusion
- Chapter Four. Management options: The decision is more important than the incision
- Management decision and planning
- Conservative treatment
- Antimicrobial therapy
- Empiric treatment
- Culture-guided treatment
- Special organisms
- Treatment duration
- Spine bracing
- Monitoring and follow-up
- Clinical monitoring
- Radiologic monitoring
- Treatment failure
- Surgical management
- Debridement±fusion and stabilization
- Surgical approaches
- Hardware-associated SOMD
- Conclusion
- Chapter Five. Intraoperative neurophysiologic monitoring—General concepts and special considerations
- Introduction to neuromonitoring
- Somatosensory-evoked potentials
- Anesthesia for SSEP
- Considerations for SSEPs in pediatric patients
- Effects of neural injury on SSEPs
- Intervention for SSEP changes
- Introduction to electromyography
- Surgical monitoring technique
- Monitoring set up for spontaneous and triggered EMG
- Anesthetic considerations and train of four (TOF)
- Baseline assessment and troubleshooting
- Reportable activity in spontaneous EMG
- Pedicle screw stimulation (PDS)
- Considerations and intervention
- Motor-evoked potentials
- Motor monitoring technique
- Motor monitoring setup
- Motor anesthesia and TOF
- Safety considerations
- Baseline assessment and troubleshooting
- Interpretation of TcMEP changes
- Intervention with TcMEP changes
- Chapter six. Surgical approaches I—Cervical spine
- Introduction
- Anterior approach
- Historical perspective and evolution of surgical techniques
- Goals of the surgical intervention
- Initial anterior debridement and fusion techniques
- Management of localized and multilevel disease and role of instrumentation
- Supplementary rods and fixation
- High-cervical spinal osteomyelitis and discitis
- Cervical cages
- Minimally invasive anterior approaches
- The surgical technique
- Anterior cervical
- Transoral
- Posterior approach
- Posterior approach and its indications
- Impact of cervical deformities in SOMD
- Neurological considerations and outcome
- Minimally invasive posterior approaches
- Minimally invasive posterior approach for anterior lesions
- Effectiveness and considerations for minimally invasive posterior approaches
- Posterior stabilization minimally invasive techniques
- Innovative irrigation techniques
- The surgical technique
- Suboccipital approach (for occipitocervical fusion)
- Atlantoaxial fusion (C1–C2 fusion)
- Subaxial posterior cervical fixation (C3 –C7)
- Minimally invasive endoscopic
- Conclusion
- Chapter Seven. Surgical approaches II—Thoracolumbar spine
- Indications for surgery
- Surgical techniques for thoracic spine osteomyelitis and discitis
- Posterior approach
- Positioning and preparations
- Surgical technique
- Posterior approach without debridement in debilitated patients
- Thoracolumbar junction
- Laminectomy
- Posterior-only approach
- Percutaneous endoscopic surgery
- Anterior trans-sternal approach
- Historical evolution
- Surgical technique
- Clinical outcomes
- Complications
- Thoracic transdiscal osteotomies
- Surgical technique
- Clinical outcomes
- Complications
- Costo-transversectomy approach
- Historical evolution
- Surgical technique
- Clinical outcomes
- Video-assisted thoracoscopic surgery
- Video assisted thoracoscopic decompression
- Lateral retroperitoneal approach to lumbar spine
- Clinical outcomes
- Minimally invasive techniques
- Percutaneous endoscopic debridement with percutaneous pedicle screws
- Percutaneous endoscopic lavage and drainage
- Percutaneous lumbar discectomy and percutaneous suction aspiration and drainage
- Percutaneous transpedicular discectomy and drainage
- Percutaneous endoscopic debridement with dilute betadine solution irrigation
- Complications
- Surgical site infections and dehiscence
- Venous thromboembolism
- Dural tears and CSF leakage
- Postoperative hematoma
- Neurological decline
- Fusion complications and outcomes
- Conclusion
- Chapter Eight. Overview of bone graft materials
- Introduction
- Biology of bone formation
- Bone grafts
- Autografts
- Iliac crest bone graft
- Local bone autograft (LBA)
- Allografts
- Demineralized bone matrix
- Synthetic materials
- Calcium phosphate compounds
- Hydroxyapatite
- Coralline hydroxyapatite
- β-Tricalcium phosphate
- Silicated graft materials
- Bone morphogenetic proteins
- Biological characteristics
- Posterior spinal fusion
- Anterior cervical fusion
- Anterior lumbar fusion
- Complications and cost-effectiveness
- Bone graft and intervertebral prothesis selection in spondylodiscitis surgery
- Advances in bone graft materials
- Conclusion
- Chapter Nine. Spinal epidural abscesses
- Introduction
- Epidemiology
- Microbiology
- Pathogenesis
- Clinical manifestation
- Back pain
- Radicular pain
- Neurological deficits
- Fever and systemic symptoms
- Spinal tenderness and swelling
- Bowel and bladder dysfunction
- Diagnosis of SEA
- Imaging studies
- Laboratory studies
- Management
- Conservative management
- Surgical management
- Complications
- Neurological complications
- Complications due to immobility
- Urinary complications
- Complications due to infection
- Conclusion
- Chapter Ten. Paediatric patients
- Introduction
- Epidemiology
- Anatomy
- Clinical presentation
- Laboratory
- Imaging
- Treatment
- Long-term complications
- Conclusion
- Chapter Eleven. Tips and tricks for surgical approaches to the infected spine and challenging cases
- Patient positioning
- Posterior approach
- Cervical spine
- Thoracic spine
- Lumbar spine
- Anterior approach
- Cervical spine
- Lumbar spine
- Lateral approach
- Risks and precautions in the lateral decubitus position
- Key risks and mitigation strategies
- Planning and localization
- Preoperative imaging considerations
- Planning the surgical approach
- Addressing preexisting instability or potential kyphotic deformity in spondylodiscitis
- Anterior debridement and fusion
- When to consider combined anterior and posterior stabilization?
- Special considerations for the lateral approach
- Debridement
- Tips for surgical technique
- Special considerations for lateral approach
- Cages
- Instrumentation and cement augmentation
- Intraoperative neuromonitoring
- Challenging cases
- Case 1
- Surgical procedure
- Postoperative outcomes and follow-up
- Clinical pearls
- Case 2
- Clinical pearls
- Case 3
- Clinical pearls
- Case 4
- Clinical pearls
- Chapter TWELVE. Outcomes, complications, and prognosis
- Introduction
- Epidemiology
- Risk factors
- Neurological impairment
- Time to diagnosis
- Hospital-acquired infections
- Comorbid conditions
- Other risk factors
- Demographic factors: Age and sex
- Etiologic agent
- Bacteremia, abscess, and relapses
- Location of spinal lesions
- Complications
- Relapses
- Abscesses
- Other foci of infection
- Other possible short-term complications
- Long-term outcomes
- Overall mortality
- Morbidity
- Chronic pain
- Neurological dysfunctions
- Standardized assessment of neurological deterioration
- Management of complications
- Cost of healthcare for osteomyelitis and spondylodiscitis
- Discitis in children
- Key points
- Chapter Thirteen. Pain management and rehabilitation
- Introduction
- Importance of pain management and rehabilitation
- Pain management
- Role of rest in pain management
- Assessing and classifying pain
- Management of neuropathic pain
- Multifactorial management of pain
- Rehabilitation
- Classification and scoring of spinal cord injury for SOMD
- Weakness and muscle atrophy
- Contractures
- Gait and balance training
- Upper limb rehabilitation
- Bladder, bowel, and sexual dysfunction
- Neuropsychological rehabilitation
- Chapter Fourteen. Fragile fortunes: Optimizing outcomes by identifying high-risk neurosurgical patients through frailty-based risk assessment
- Introduction
- Impact on patient outcomes
- Morbidity and mortality
- Economic burden
- Quality of life
- Prognostic indicators
- Rehabilitation and physical therapy
- Long-term follow-up and monitoring
- Preoperative risk assessment
- Frailty indices
- Clinical frailty scale
- FRAIL assessment
- Modified frailty index (mFI)
- Metastatic spinal tumor frailty index (MSTFI)
- Hospital frailty risk score (HFRS)
- Risk Analysis Index (RAI)
- Adult spinal deformity frailty index (ASD-FI)
- Frailty and spine infections
- Orthopedic trauma patients with bone and implant-associated infections
- Spine tuberculosis
- Spinal epidural abscess
- Frailty and patient outcomes
- Conclusion
- Index
- Edition: 1
- Published: November 15, 2024
- Imprint: Academic Press
- No. of pages: 492
- Language: English
- Paperback ISBN: 9780443191336
- eBook ISBN: 9780443157066
DH
Dia R Halalmeh
Dr. Halalmeh received his medical degree from the University of Jordan in Amman, Jordan. He conducts translational research in minimally invasive and complex spine surgery, advanced surgical approaches to the spine, and utility of bone grafts, especially autologous local bone. He completed a clerkship at Massachusetts General Hospital-Harvard Medical School in the Neurosurgery department and then a fellowship in clinical research at Detroit Medical Center-Wayne State University, producing more than 20 peer-reviewed publications and more than 8 book chapters. Dr Halalmeh’s research focuses on promoting minimally invasive spine techniques and modern surgical technology that minimize tissue trauma during spine surgical procedures.
Affiliations and expertise
Postdoctoral Research Fellow, Department of Neurosurgery Hurley Medical Center USAMM
Marc Moisi
Marc Moisi is Chief of Neurosurgery, DMC Detroit Receiving Hospital.
Affiliations and expertise
Chief of Neurosurgery, DMC Detroit Receiving HospitalRead Osteomyelitis and Discitis of the Spine on ScienceDirect