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Recurrence rate after posterior percutaneous screw fixation without anterior debridement for pyogenic spondylitis compared with conservative treatment: a propensity score-matched analysis

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Abstract

Purpose

Previous studies have shown that percutaneous pedicle screw (PPS) posterior fixation without anterior debridement for pyogenic spondylitis can improve patient quality of life compared with conservative treatment. However, data on the risk of recurrence after PPS posterior fixation compared with conservative treatment is lacking. The aim of this study was to compare the recurrence rate of pyogenic spondylitis after PPS posterior fixation without anterior debridement and conservative treatment.

Methods

The study was conducted under a retrospective cohort design in patients hospitalized for pyogenic spondylitis between January 2016 and December 2020 at 10 affiliated institutions. We used propensity score matching to adjust for confounding factors, including patient demographics, radiographic findings, and isolated microorganisms. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for recurrence of pyogenic spondylitis during the follow-up period in the matched cohort.

Results

148 patients (41 in the PPS group and 107 in the conservative group) were included. After propensity score matching, 37 patients were retained in each group. PPS posterior fixation without anterior debridement was not associated with an increased risk of recurrence compared with conservative treatment with orthosis (HR, 0.80; 95% CI, 0.18–3.59; P = 0.77).

Conclusions

In this multi-center retrospective cohort study of adults hospitalized for pyogenic spondylitis, we found no association in the incidence of recurrence between PPS posterior fixation without anterior debridement and conservative treatment.

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Acknowledgements

We thank Dr. Guy Harris of Dmed (www.dmed.co.jp) for his support with the writing of the manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Soichiro Masuda, Takayoshi Shimizu, Shunsuke Fujibayashi, Bungo Otsuki, Koichi Murata & Shuichi Matsuda

  2. Department of Orthopaedic Surgery, Fukui Red Cross Hospital, Fukui, Japan

    Takashi Sono

  3. Department of Orthopaedic Surgery, Wakayama Red Cross Hospital, Wakayama, Japan

    Yasuyuki Tamaki

  4. Department of Orthopaedic Surgery, Kobe Central General Hospital, Kobe, Japan

    Eijiro Onishi

  5. Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan

    Mitsuru Takemoto

  6. Department of Orthopaedic Surgery, Gakkentoshi Hospital, Kyoto, Japan

    Seiichi Odate

  7. Department of Orthopaedic Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan

    Hiroaki Kimura

  8. Department of Orthopaedic Surgery, Kansai Electric Power Hospital, Osaka, Japan

    Masanori Izeki

  9. Department of Orthopaedic Surgery, Tenri Hospital, Nara, Japan

    Takuya Tomizawa

  10. Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan

    Naoya Tsubouchi

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  1. Soichiro Masuda
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  2. Takayoshi Shimizu
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  12. Shunsuke Fujibayashi
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  13. Bungo Otsuki
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  14. Koichi Murata
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  15. Shuichi Matsuda
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Correspondence to Soichiro Masuda.

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Masuda, S., Shimizu, T., Sono, T. et al. Recurrence rate after posterior percutaneous screw fixation without anterior debridement for pyogenic spondylitis compared with conservative treatment: a propensity score-matched analysis. Eur Spine J 32, 4265–4271 (2023). https://doi.org/10.1007/s00586-023-07800-7

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  • DOI: https://doi.org/10.1007/s00586-023-07800-7

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