Oral Cavity Infection: An Underestimated Source of Pyogenic Spondylodiscitis?

Romagna, Alexander; Tröltzsch, Matthias; Birkenmaier, Christof; Schwartz, Christoph; Suchorska, Bogdana and Zausinger, Stefan (2018): Oral Cavity Infection: An Underestimated Source of Pyogenic Spondylodiscitis? In: Journal of Neurological Surgery Part A-Central European Neurosurgery, Vol. 79, No. 3: pp. 218-223

Abstract

Background The incidence of pyogenic spondylodiscitis is increasing;however, the source of infection often remains obscure. We analyzed predisposing factors, pathogens, and outcome of patients undergoing surgical and/or conservative treatment of spondylodiscitis with a focus on the diagnostic work-up including a comprehensive maxillofacial assessment. Patients The analysis of prognostic factors comprised comorbidities, nicotine dependence, symptom duration, and oral cavity peculiarities. After a standardized diagnostic work-up, a detailed examination of the oral cavity was also performed. The outcome analysis included assessment of the patients' clinical status. Results Forty-one patients with pyogenic spondylodiscitis were investigated of whom 24% had undergone spinal surgery within 4 weeks before the infection. A total of 29% of patients were found to have a concomitant bacterial oral cavity disease, and in 22% the definitive source of infection remained unidentified. Among the 12 patients with oral cavity infections, 10 patients had periodontitis;8, root canal pathologies;6, periapical lesions, and another 8 patients, caries. In 25% of these patients, typical oral cavity pathogens were found in the intervertebral disk. The prevalence of oral cavity infections was associated with a history of nicotine dependence ( p =0.003). All other analyzed comorbidities did not differ compared with patients without an oral cavity focus. Conclusion Oral cavity infections appear to be a frequent source of pyogenic spondylodiscitis, with smoking its most relevant associated risk factor. In case of an unidentified infection focus, a detailed diagnostic work-up including a mandatory maxillofacial assessment is strongly recommended.

• Item Type: Journal article
• Faculties: Medicine
• Subjects: 600 Technology > 610 Medicine and health
• ISSN: 2193-6315
• Language: English