Vertebral osteomyelitis is an infection of the intervertebral disk and adjacent vertebral plates with a non-negligible risk of neurological complications and handicap. If there are clear recommendations dealing with antibiotic therapy and surgery indications for this pathogen, the question of the immobilization will be remaining debate. The aim of the study was to describe protocols and practices for the immobilization of vertebral osteomyelitis in different French hospitals and bone and joint infections Centers. The secondary objectives were to evaluate the frequency of neurological complications in a large prospective cohort, and to identify clinical and imaging risk factors for neurological complications. The investigators also aim to search for association between type and duration of spine immobilization and neurological status at the end of follow-up.
Study design is descriptive, prospective, multicentric, and the investigators have a single database centralized in Nantes University Hospital. Patient's data will be conserved and trapped anonymously and patients all give oral consent. Information letter is given to each patient. Typical study calendar : Baseline : * Patient information (letter and oral consent) * Clinical data and comorbidities collection * Neurological examination * Spine X-ray * MRI or CT-scan imaging to confirm diagnosis During Hospitalization * Date collection : spine immobilization modalities (type, duration, changes…), duration of bed rest * Other treatments (antibiotic therapy : molecules and duration) * Daily neurological examination 3 months follow-up visit : (if usually done by physician) * Clinical and neurological examination * Spine immobilization assessment * Spine X-ray * Oswestry questionary 6 months follow-up visit : finale visit (if usually done by physician) * Clinical and neurological examination * Spine immobilization assessment * Spine X-ray * Oswestry questionary
Study Type
OBSERVATIONAL
Enrollment
250
Evaluation of the frequency of neurological complications in a large prospective cohort, and to identify clinical and imaging risk factors for neurological complications. We search for association between type and duration of spine immobilization and neurological status at the end of follow-up
Angers University Hospital
Angers, France
Clermont ferrand University Hospital
Clermont-Ferrand, France
La Roche Sur Yon Hospital
La Roche-sur-Yon, France
Nantes University Hospital
Nantes, France
Paris University Hospital
Paris, France
Quimper Hospital
Quimper, France
Rennes University Hospital
Rennes, France
Saint-Nazaire Hospital
Saint-Nazaire, France
Tours University Hospital
Tours, France
Qualitative description of main types of spine immobilization
Type of bracing : smooth or rigid bracing, highness of bracing (cervical, thoracic, lumbar spine or both and level of the highest and lowest vertebrae included).
Time frame: inclusion
Frequency of neurological complications
Percentage of neurological complication at baseline, 3 and 6 months follow-up) * Percentage of major neurological signs (sphincter dysfunction and/or motor deficit and ASIA score) at baseline, 3 and 6 months follow-up * Percentage of minor neurological signs (radicular pain, reflex abolition, hypoesthesia) at baseline, 3 and 6 months follow-up
Time frame: inclusion, month 3 and month 6
MRI signs at baseline
Number of vertebrae involved, destruction of posterior arch, destruction of vertebrae, kyphosis, epidural phlegmon, spinal cord hypersignal, dural sac compression, anterior effacement of subarachnoidal space Oswestry functional score at 3 and 6 months follow-up. Association between type and duration of spine immobilization and neurological complication
Time frame: inclusion, month 3 and month 6
Oswestry functional score at 3 and 6 months follow-up
Association between type and duration of spine immobilization and neurological complication
Time frame: inclusion, month 3 and month 6
Duration of Spine immobilization
Evaluation of the duration of immobilization of the spine
Time frame: month 6
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