The spine journal : official journal of the North American Spine Society · 2018
Clinical effect of early bisphosphonate treatment for pyogenic vertebral osteomyelitis with osteoporosis: An analysis by the Cox proportional hazard model.
Оценочное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Kim Jihye, Jang Seung Bo, Kim Seok Woo, Oh Jae-Keun, Kim Tae-Hwan
Аннотация
BACKGROUND CONTEXT: Patients with pyogenic vertebral osteomyelitis (PVO) are expected to have an increased risk of bone loss. Therefore, early bisphosphonate therapy would be clinically effective for PVO patients with osteoporosis.
PURPOSE: This study aimed to investigate the effect of bisphosphonate on clinical outcomes of PVO patients with osteoporosis.
STUDY DESIGN/SETTING: A retrospective comparative study.
PATIENT SAMPLE: PVO patients with osteoporosis.
OUTCOME MEASURES: Four events of interest for Cox proportional hazard model included surgical treatment, recurrence of infection, subsequent fracture of adjacent vertebral bodies, and death.
METHODS: PVO patients were divided into three groups: group A (initiation of bisphosphonate within 6 weeks after PVO diagnosis), group B (initiation of bisphosphonate between 6 weeks and 3 months after PVO diagnosis), and group C (no treatment for osteoporosis). Cox proportional hazard model was used for the four events of interest.
RESULTS: A total of 360 PVO patients with osteoporosis were investigated for the four events of interest. Group A had significantly lower hazard ratios for undergoing later (>6 weeks after diagnosis) surgery than group C (p = .014) despite similar occurrences of overall surgery. A significant difference was also observed in the occurrence of subsequent fractures at adjacent vertebral bodies (p = .001 for model 1 and p = .002 for model 2). Groups A and B had significantly lower hazard ratios for subsequent fracture than group C. No significant differences were observed in the hazard ratios of recurrence and death among the three groups.
CONCLUSIONS: Early bisphosphonate treatment in PVO patients with osteoporosis was associated with a significantly lower occurrence of subsequent vertebral fracture at adjacent vertebral bodies and lower occurrence of subsequent surgery.
PURPOSE: This study aimed to investigate the effect of bisphosphonate on clinical outcomes of PVO patients with osteoporosis.
STUDY DESIGN/SETTING: A retrospective comparative study.
PATIENT SAMPLE: PVO patients with osteoporosis.
OUTCOME MEASURES: Four events of interest for Cox proportional hazard model included surgical treatment, recurrence of infection, subsequent fracture of adjacent vertebral bodies, and death.
METHODS: PVO patients were divided into three groups: group A (initiation of bisphosphonate within 6 weeks after PVO diagnosis), group B (initiation of bisphosphonate between 6 weeks and 3 months after PVO diagnosis), and group C (no treatment for osteoporosis). Cox proportional hazard model was used for the four events of interest.
RESULTS: A total of 360 PVO patients with osteoporosis were investigated for the four events of interest. Group A had significantly lower hazard ratios for undergoing later (>6 weeks after diagnosis) surgery than group C (p = .014) despite similar occurrences of overall surgery. A significant difference was also observed in the occurrence of subsequent fractures at adjacent vertebral bodies (p = .001 for model 1 and p = .002 for model 2). Groups A and B had significantly lower hazard ratios for subsequent fracture than group C. No significant differences were observed in the hazard ratios of recurrence and death among the three groups.
CONCLUSIONS: Early bisphosphonate treatment in PVO patients with osteoporosis was associated with a significantly lower occurrence of subsequent vertebral fracture at adjacent vertebral bodies and lower occurrence of subsequent surgery.