Evidence map›Paper›PMID 39223430›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024

Impact of causative organism identification on clinical outcomes after minimally invasive posterior fixation for thoracolumbar pyogenic spondylitis: multicenter retrospective cohort study.

Hisanori Gamada, Toru Funayama, Tomoyuki Asada, Yusuke Setojima, Takane Nakagawa, Takahiro Sunami, Kotaro Sakashita, Yosuke Ogata, Shun Okuwaki, Kaishi Ogawa and 9 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Hisanori GamadaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Toru FunayamaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan. funatoru3@md.tsukuba.ac.jp.ORCID 0000-0002-7325-4357
Tomoyuki AsadaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Yusuke SetojimaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Takane NakagawaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Takahiro SunamiDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Kotaro SakashitaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Yosuke OgataDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Shun OkuwakiDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Kaishi OgawaDepartment of Orthopaedic Surgery, Showa General Hospital, Kodaira, Tokyo, Japan.
Yosuke ShibaoDepartment of Orthopaedic Surgery, Ibaraki Western Medical Center, Chikusei, Ibaraki, Japan.
Hiroshi KumagaiDepartment of Orthopaedic Surgery, Ichihara Hospital, Tsukuba, Ibaraki, Japan.
Katsuya NagashimaDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital, Mito Clinical Education and Training Center, Mito Kyodo General Hospital, Mito, Ibaraki, Japan.
Kengo FujiiDepartment of Orthopaedic Surgery, Showa General Hospital, Kodaira, Tokyo, Japan.
Yosuke TakeuchiDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital, Mito Clinical Education and Training Center, Mito Kyodo General Hospital, Mito, Ibaraki, Japan.
Masaki TatsumuraDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital, Mito Clinical Education and Training Center, Mito Kyodo General Hospital, Mito, Ibaraki, Japan.
Itsuo ShiinaDepartment of Orthopaedic Surgery, Moriya Daiichi General Hospital, Moriya, Ibaraki, Japan.
Masafumi UesugiDepartment of Orthopaedic Surgery, Ibaraki Seinan Medical Center Hospital, Sashima, Ibaraki, Japan.
Masao KodaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to evaluate the difference in treatment duration and unplanned additional surgeries between patients with unidentified causative organisms on empiric antibiotics and those with identified organisms on selective antibiotics in treating thoracolumbar pyogenic spondylitis with minimally invasive posterior fixation.

methodsThis multicenter retrospective cohort study included patients with thoracolumbar pyogenic spondylitis refractory to conservative treatment who underwent minimally invasive posterior fixation. Patients were divided into the identified (known causative organism) and unidentified groups (unknown causative organism). We analyzed data on demographics, antibiotic use, surgical outcomes, and infection control indicators.

resultsWe included 74 patients, with 52 (70%) and 22 (30%) in the identified and unidentified groups, respectively. On admission, the identified group had higher C-reactive protein (CRP) levels and more iliopsoas abscesses. The duration to postoperative CRP negative was similar in the identified and unidentified groups (7.13 vs. 6.48 weeks, p = 0.74). Only the identified group had unplanned additional surgeries due to poor infection control, affecting 6 of 52 patients (12%). Advanced age and causative organism identification increased the additional surgery odds (odds ratio [OR], 8.25; p = 0.033 and OR, 6.83; p = 0.034, respectively).

conclusionThe use of empiric antibiotics in minimally invasive posterior fixation was effective without identifying the causative organism and did not prolong treatment duration. In patients with identified organisms, 12% required unplanned additional surgery, indicating a more challenging infection control. Causative organism identification was associated with the need for additional surgery, suggesting a more cautious treatment strategy for these patients.

Indexed as

Lumbar VertebraeMinimally Invasive Surgical ProceduresSpondylitisThoracic VertebraeAdultAgedAnti-Bacterial AgentsFemaleHumansMaleMiddle AgedRetrospective StudiesSpinal FusionTreatment OutcomeAnti-Bacterial AgentsCausative organismMinimally invasive spine surgeryMulticenter studyPosterior fixationPyogenic spondylitis

Identifiers

PMID39223430

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.