Case of successful treatment of spinal infection in a patient with high comorbidity and septic manifestations
A. V. Yarikov,
A. A. Vishnevsky,
A. S. Filyaeva,
E. A. Pavlova,
O. A. Perlmutter,
A. P. Fraerman,
V. N. Voloshin https://doi.org/10.34215/1609-1175-2024-1-82-87
Abstract
The study presents a clinical case of complex treatment of a patient with high comorbidity (Charlson comorbidity index = 6 points) who had severe sepsis (SOFA score = 8 points) with multiple foci of pyogenic infection (spinal epiduritis, paravertebral and subdural abscesses, purulent meningitis, bilateral lower lobe pneumonia). The syndrome-based approach with the use of minimally invasive approaches in the early stages (no later than 12 hours from the onset of clinical manifestations of the disease) ensured a favorable outcome. Based on the results of surgical treatment, a conclusion was made about the tactics of surgical treatment in patients with spinal infection against the background of sepsis.
About the Authors
A. V. Yarikov
Privolzhsky District Medical Center ; City Clinical Hospital №. 39 ; Lobachevsky National Research Nizhny Novgorod State University
Russian Federation
Russian Federation
Anton V. Yarikov, Cand. Sci. (Med.), neurosurgeon, orthopedic traumatologist
2 Nizhne-Volzhskaya Embankment str., Nizhny Novgorod, Nizhny Novgorod region, 603159
A. A. Vishnevsky
St. Petersburg Research Institute of Phthisiopulmonology
Russian Federation
Russian Federation
St. Petersburg
A. S. Filyaeva
City Clinical Hospital №. 39
Russian Federation
Russian Federation
Nizhny Novgorod
E. A. Pavlova
Far Eastern District Medical Center
Russian Federation
Russian Federation
Vladivostok
O. A. Perlmutter
City Clinical Hospital №. 39
Russian Federation
Russian Federation
Nizhny Novgorod
A. P. Fraerman
City Clinical Hospital №. 39
Russian Federation
Russian Federation
Nizhny Novgorod
V. N. Voloshin
Federal Siberian Scientifi c and Clinical Center
Russian Federation
Russian Federation
Krasnoyarsk
References
1. Goncharova MY, Levchik EY. Subdural abscesses of the spinal cord. Infekcii v Hirurgii. 2013;11(1):17–20 (In Russ.).
2. Goncharov MY, Sakovich VP, Levchik EY. Systemic infl ammatory response in the surgical treatment of nonspecifi c purulent diseases of the spine. Bulletin of the East Siberian Scientifi c Center of the Siberian Branch of the Russian Academy of Medical Sciences. 2012;86(4–2):39–42 (In Russ.).
3. Chehonatskiy VA, Dreval ON, Kuznetsov AV, Muhina OV, Chapandze GN, Magomedov HA, Gorozhanin AV, Sidorenko VV. Treatment of thoracic spine spondylodiscitis in a patient who underwent COVID-19 (clinical case). Saratov Journal of Medical Scientifi c Research. 2021;17(4):724–7 (In Russ.). doi: 002-022-06:616.24:578.834.1]-089(045)
4. Firsov SA, Snopko SV, Kornilova IV, Tumorin LS. Purulent spinal epiduritis: a hidden threat. Pacific Medical Journal 2015;62(4):92–4 (In Russ.).
5. Goncharov MY, Sakovich VP, Levchik EY. Spinal epidural abscess. Modern aspects of diagnostics and provision of specialized care. Ural Medical Journal. 2012;97(5):67–70 (In Russ.).
6. Goncharov MY, Manukovskiy VA, Levchik EY, Masutina DD. Features of surgical treatment of isolated spinal epidural abscesses and prevention of the development of postlamynectomy syndrome. Russian Journal of Neurosurgery. 2022;14(1–2):29–37 (In Russ.).
7. Yarikov AV, Fraerman AP, Perlmutter OA, Denisov AA, Masevnin SV, Smirnov II, Lavrenuk AN. Nonspecifi c purulent-infl ammatory lesions of the spine: spondylodiscitis, epiduritis. Russian Sklifosovsky Journal Emergency Medical care. 2019; 8 (2): 175–85 (In Russ.). doi: 10.23934/2223-9022-2019-8-2-175-185
8. Sitnik AV, Obolenskiy VN, Lvov IS, Kordonskiy AY, Rozhanskiy SA. Multi-stage treatment of nonspecifi c purulent spondylodiscitis of the cervical spine (clinical observation). Neurosurgery. 2021;23(2):93–102 (In Russ.). doi: 10.17650/1683-3295-2021-23-2-93-102
9. Bazarov A.Y., Rebyatnikova M.A., Ortenberg E.A. Hematogenic osteomyelitis of the spine in the Tyumen region: clinical and bacteriological characteristics. Universitetskaja Medicina Urala. 2015;2(2-3):7–10 (In Russ.).
10. Goncharov MY, Masutina DD. Intradural spinal cord abscesses in neurological practice. Ural Medical Journal. 2019;181(13):19–23 (In Russ.). doi: 10.25694/URMJ.2019.13.09
11. Mushkin AY, Vishnevskiy AA. Clinical recommendations for the diagnosis of infectious spondylitis (draft discussion). Medalliance. 2018;3:65– 74 (In Russ.).
12. Yarikov AV, Perlmutter OA, Fraerman AP, Smirnov II, Istrelov AK, Muhin AS, Simonov AE, Yaksargin AV. Vertebral infection: spondylodiscitis, spinal epiduritis. Neurology and Neurosurgery. Eastern Europe. 2019;9(1):100–14 (In Russ.).
13. Snopko SV, Firsov SA, Kornilova IV, Tumorin LS, Shevchenko VP. Features of diagnosis and treatment of purulent spinal epiduritis. Spine Surgery. 2015;12(4):84–7 (In Russ.). doi: 10.14531/ss2015.4.84-87
14. Kochnev EY, Lylin SV, Muhtyaev SV, Mesheryagina IA. Minimally invasive technologies for the treatment of osteomyelitis of the spine. Siberian Medical Review. 2021; 127(1):104–10 (In Russ.). doi: 10.20333/2500136-2021-1-104-110
15. Goncharov MY, Masutina DD. Neurological disorders syndrome as a predictor of early diagnosis and a criterion for the effectiveness of surgical treatment of nonspecifi c purulent diseases of the spine. Vestnik Ural’skoj Medicinskoj Akademicheskoj Nauki. 2020;17(2):175–86 (In Russ.). doi: 10.22138/2500-0918-2020-17-2-175-186
Review
For citations:
Yarikov A.V., Vishnevsky A.A., Filyaeva A.S., Pavlova E.A., Perlmutter O.A., Fraerman A.P., Voloshin V.N. Case of successful treatment of spinal infection in a patient with high comorbidity and septic manifestations. Pacific Medical Journal. 2024;(1):82-87. (In Russ.) https://doi.org/10.34215/1609-1175-2024-1-82-87
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