Evidence map›Paper›PMID 40069736›Full record

ArticleBMC musculoskeletal disorders2025

Gram-negative rods are associated with prolonged treatment in patients with thoracolumbar pyogenic spondylitis after minimally invasive posterior fixation compared with gram-positive cocci: a multicenter retrospective cohort study.

Hisanori Gamada, Toru Funayama, Kengo Fujii, Yosuke Ogata, Yusuke Setojima, Takane Nakagawa, Takahiro Sunami, Kotaro Sakashita, Shun Okuwaki, Kaishi Ogawa and 8 more

Abstract readMulticenter StudyComparative Study
In one paragraph

Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

18 authors.

Hisanori GamadaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Toru FunayamaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. funatoru3@md.tsukuba.ac.jp.
Kengo FujiiDepartment of Orthopaedic Surgery, Showa General Hospital, Kodaira, Tokyo, Japan.
Yosuke OgataDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Yusuke SetojimaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Takane NakagawaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Takahiro SunamiDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Kotaro SakashitaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Shun OkuwakiDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, 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.
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, Tsukuba, Ibaraki, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study compared patient characteristics, clinical outcomes, and antibiotic durations between patients undergoing posterior fixation for gram-negative rods (GNR) or gram-positive cocci (GPC) thoracolumbar pyogenic spondylitis.

methodsIn this multicenter retrospective cohort study, 53 patients who underwent minimally invasive posterior fixation for thoracolumbar pyogenic spondylitis were categorized into a GPC or GNR group based on the identified causative organisms. Patient characteristics, surgical outcomes, and postoperative infection control were compared between the two groups to identify factors affecting antibiotic duration.

resultsThe patients in the GNR group (n = 14) were older (77.2 years versus 70.1 years; p = 0.008), had a higher incidence of a history of abdominal-pelvic infections (4 versus 0; p = 0.003), required longer preoperative antibiotics (5.9 weeks versus 3.0 weeks; p = 0.035), and had more unplanned additional surgeries due to poor infection control (n = 4 versus n = 1; p = 0.014) than those in the GPC group (n = 39). Furthermore, GNR infection independently predicted longer preoperative antibiotic duration (p = 0.002, β = 0.43).

conclusionsPyogenic spondylitis with GNR is associated with the need for prolonged antibiotic treatment and higher rates of unplanned additional surgeries due to poor infection control as compared to GPC-associated pyogenic spondylitis. Older age and a history of abdominal-pelvic infections tend to complicate the management in these patients; therefore, tailored treatment strategies are required to optimize treatment duration and minimize complications. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Anti-Bacterial AgentsGram-Negative Bacterial InfectionsGram-Positive Bacterial InfectionsGram-Positive CocciLumbar VertebraeSpondylitisThoracic VertebraeAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedMinimally Invasive Surgical ProceduresRetrospective StudiesAnti-Bacterial AgentsGram-negative rodsGram-positive cocciMulticenter studyPosterior fixationPyogenic spondylitis

Identifiers

PMID40069736
PMCPMC11895314

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Registered trials

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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.