Infectious Spondylitis: Characteristics of Geriatric Patients and Significance of Surgery

Purpose: The goal of this study is to identify the characteristics and common problems of geriatric patients with infectious spondylitis and to explore possible solutions for them. Methods: This is a case series presentation with retrospective comparative study. Out of 26 patients with infectious spondylitis who were treated as inpatients, 18 geriatric patients aged 70 or older were studied in detail and compared with non-geriatric patients with regard to systemic complications, psychological symptoms, clinical stages, pathogenic factors, surgeries and length of hospital stay. Illustrative cases are described to demonstrate our strategy for infectious spondylitis. Results: In geriatric patients with infectious spondylitis, certain perioperative complications including cardiac complications, psychological symptoms and pseudomembranous enterocolitis were recognized to be characteristics of the patient population, although no correlations were significant because of the small number of cases. In most geriatric patients, clinical manifestations indicated a subacute or chronic stage of infection without colic pain or high fever. Eight of 18 geriatric patients underwent surgery including discectomy, fusion surgery or removal of previous instrumentation. Subsequently, infection was controlled in all 18 patients. Conclusion: To improve outcomes in geriatric patients with infectious spondylitis, it is critically important to diagnose and treat any complications in their early stages in conjunction with the relevant hospital department. Additionally, early nutritional support, rehabilitation and treatment for psychological problems should be performed to prevent disuse syndrome.