Association between radiographic and functional outcome in vertebral osteomyelitis SPONDIMMO, a 6-month prospective multicenter cohort - 30/11/23
, Guillaume Coiffier b, Christelle Darrieutort-Laffite a, Sophie Godot c, Sebastien Ottaviani d, Julien Henry e, Julia Brochard f, Grégoire Cormier g, Marion Couderc h, Emmanuel Hoppe i, Denis Mulleman j, Lydie Khatchatourian k, Aurélie Le Thuaut l, Géraldine Bart m, Benoit Le Goff aHighlights |
• | After 3 months, all the radiographic features worsened. |
• | Between 3 and 6 months, among the different X-ray abnormalities, only the complete fusion progressed. |
• | Sixteen percent of the patients with vertebral osteomyelitis (VO) still present with a severe to major disability at 6 months. |
• | Vertebral destruction was associated with a higher disability at 6 months. |
• | No differences in radiological progression were observed depending on immobilization. |
Abstract |
Objectives |
This study aimed to describe radiographic and functional evolution over 6 months in a large cohort of VO patients.
Methods |
We prospectively recruited patients with VO from 2016 to 2019 in 11 French centers. X-rays were performed at baseline, 3 months, and 6 months to assess progression using structural and static criteria. Functional impairment was evaluated using the Oswestry Disability Index (ODI) at 3 months and 6 months.
Results |
Two hundred and twenty-two patients were included. Mean age was 67.8±14 years, mostly men (67.6%). After 3 months, there was a significant increase in vertebral fusion (16.4% vs 52.7%), destruction of vertebral bodies (10.1% vs 22.8%), and of all the static features (frontal angulation (15.2% vs 24.4%), segmental (34.6% vs 56%) and regional (24.5% vs 41%) kyphosis). From 3 to 6 months, among the different X-ray abnormalities, only the complete fusion progressed significantly (16.6% vs 27.2%). Median ODI showed significant improvement from 3 to 6 months (24, IQR [11.5–38] vs 16, IQR [6–34]). At 6 months, 14.1% of the patients had a severe disability, 2% a major disability. The persistence of vertebral destruction at 6 months was associated with a higher ODI (16, IQR [7.5–30.5] vs 27, IQR [11.5–44.5]). No differences in radiological progression were observed with immobilization using a rigid brace.
Conclusion |
Our study demonstrates structural and static radiographic progression after 3 months. Only the complete fusion progressed over the long-term. Functional impairment was associated with persistence of vertebral destruction.
Le texte complet de cet article est disponible en PDF.Keywords : Vertebral osteomyelitis, Spondylodiscitis, X-ray, Radiography, Follow-up
Plan
Vol 90 - N° 6
Article 105600- décembre 2023 Retour au numéro
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