Surgery linked with lower mortality, recurrence rates for vertebral osteomyelitis
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Key takeaways:
- Surgical treatment yielded better 1-year outcomes for patients with vertebral osteomyelitis compared with nonoperative treatment.
- Nonoperative treatment was an independent risk factor for treatment failure.
Patients with vertebral osteomyelitis who underwent surgical intervention had lower rates of mortality and recurrence at 1 year compared with patients who received nonoperative treatment, according to published results.
Researchers at the University of Cologne in Germany performed a retrospective study on data from 313 patients with vertebral osteomyelitis who underwent surgery and 42 patients with vertebral osteomyelitis who received nonoperative treatment between 2008 and 2020. According to the study, the primary outcome measure was treatment failure defined by mortality and 1-year recurrence rates.
Researchers noted 69% of patients who underwent surgery and 47.5% of patients who received nonoperative treatment had an American Society of Anesthesiologists score of greater than 2. In addition, they noted 30.4% of patients who underwent surgery and 11.9% of patients who received nonoperative treatment had osteomyelitis in the thoracic spine.
Researchers found 4.2% of patients who underwent surgery and 14.3% of patients who received nonoperative treatment had endocarditis. Recurrence rates at 1 year after diagnosis were 5.4% in the surgical group and 16.7% in the nonoperative group.
After propensity matching, researchers found patients who underwent nonoperative treatment had a sevenfold higher mortality rate at 1 year (25% vs. 3.7%) and an almost threefold higher rate of treatment failure (42.9% vs. 14.8%).
Researchers concluded that nonoperative treatment (OR = 2.950) and bacteremia (OR = 2.296) were independent risk factors for treatment failure in this patient population.
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