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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 :
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
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| protocols and practices for the immobilization of vertebral osteomyelitis in different French hospitals and bone and joint infections Centers | Other | 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 |
| Measure | Description | Time Frame |
|---|---|---|
| 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). | inclusion |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of neurological complications | Percentage of neurological complication at baseline, 3 and 6 months follow-up)
| inclusion, month 3 and month 6 |
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Inclusion Criteria:
Exclusion Criteria:- Spine device infection
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Baseline :
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 questionnary
6 months follow-up visit : finale visit (if usually done by physician)
Clinical and neurological examination
Spine immobilization assessment
Spine X-ray
Oswestry questionnary
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| Name | Affiliation | Role |
|---|---|---|
| Benoit Le Goff, PH | Nantes University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Angers University Hospital | Angers | 49000 | France | |||
| Clermont ferrand University Hospital |
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| 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 | 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 | inclusion, month 3 and month 6 |
| Duration of Spine immobilization | Evaluation of the duration of immobilization of the spine | month 6 |
| Clermont-Ferrand |
| 63000 |
| France |
| La Roche Sur Yon Hospital | La Roche-sur-Yon | 85000 | France |
| Nantes University Hospital | Nantes | 44000 | France |
| Paris University Hospital | Paris | 75020 | France |
| Quimper Hospital | Quimper | 29107 | France |
| Rennes University Hospital | Rennes | 35000 | France |
| Saint-Nazaire Hospital | Saint-Nazaire | 44606 | France |
| Tours University Hospital | Tours | 37000 | France |
| ID | Term |
|---|---|
| D015299 | Discitis |
| ID | Term |
|---|---|
| D013166 | Spondylitis |
| D001850 | Bone Diseases, Infectious |
| D007239 | Infections |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D013122 | Spinal Diseases |
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