Analysis of spinal infections followed in our hospital between 2019 and 2023 from the neurosurgical perspective

Introduction-Purpose: Spinal infections are complex pathologies that need to be addressed with a multisystemic approach. Due to the high morbidity and mortality risks of these infections, which affect the spinal canal and related bone, soft tissue and vascular structures, important parameters in the follow-up and treatment processes need to be evaluated holistically. Although spinal infections most commonly present as spondylodiscitis, they can progress with more severe conditions such as paraspinal/paravertebral abscess, osteomyelitis and direct infection of the spinal canal, and accompanying soft tissue infections. Detection of silently progressing infections in the early period with distinctive radiological and biochemical findings is very important in ensuring the success of the follow-up and treatment process and preventing possible sequelae. Spinal infections may occur when the causative microorganism reaches the spinal canal and related structures through hematogenous, lymphatic or direct inoculation, or may occur after previous spinal surgeries. In our study, the radiological and biochemical data of 164 patients, the antibiotics and other treatments they received, the duration of hospital stay and the risk of existing infections after surgical interventions. A general evaluation of spinal infections was made from a neurosurgical perspective by examining its relationship with the disease, and it was aimed to contribute to the diagnosis, follow up and treatment processes. Materials and Methods: Biochemical, microbiological and radiological data of patients diagnosed with spinal infection who received follow-up and treatment at Ankara Bilkent City Hospital between 2019 and 2024 were retrospectively examined. The duration of hospitalization of the patients, the relationship between their current infections and surgical intervention, whether there were radiological findings of spinal infection, the antibiotic treatments used, causative microorganisms, and infective parameters were evaluated. Results: In our study, 46 of 164 patients (73 women and 91 men) over the age of 18 were related to surgery (28.04%), while 118 (71.95%) were patients who did not undergo any spinal intervention. 105 of 164 patients (64.02%) were followed up and treated on an outpatient basis, and 59 patients (35.97%) received treatment through hospitalization. Hypertension and coronary artery disease in 58 of 164 patients (35.36%), diabetes mellitus in 36 patients (21.95%); Chronic renal failure in 8 patients (4.26%), rheumatoid arthritis in 17 patients (10.36%), allergy in four patients (2.43%), asthma in seven patients (4.26%), goiter in ten patients (6%). .09), Parkinson's disease in three patients (1.82%), osteoporosis in four patients (2.43%), accompanying malignancies in four patients (2.43%), liver failure in one patient (0.60%), and osteoporosis in four patients (2.43%). HbsAG positivity was detected (2.43%). While 10 of the patients had Tuberculosis (TBC) spondylodiscitis (6.09%), Brucella spondiodiscitis was detected in 65 patients (39.63%). Magnetic Resonance imaging showed diagnostic findings of spondylodiscitis and other spinal infections in 142 patients (86.58%). The most common microorganism in 164 patients was Escherichia Coli with 7.36%, the second most common microorganism was Staphylococcus aureus with 6.75%, and the third most common microorganism was Staphylococcus epidermidis with 5.52%. Ciprofloxacin, from the fluoroquinolone group, was the most frequently preferred antibiotic with a rate of 39.26%. Conclusion: In our study, the biochemical and radiological findings of the patients, the percentage distribution of causative microorganisms and the antibiotics used were found to be similar to literature studies. The distinguishing features of our study are the relationship between patients' spinal infection symptoms and surgery and the separate evaluation of all parameters according to the presence of surgical intervention. Future literature studies with more patients will allow obtaining more reliable data that will affect the follow-up and treatment process. brucella Keywords: spinal infections, spondylodiscitis, paraspinal abscess, paravertebral abscess, spondylodiscitis, spondylodiscitis, soft tissue infections tuberculous spondylodiscitis, pyogenic