{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:29:52Z","timestamp":1793194192283,"version":"4.5.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spinal Cord Ser Cases"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Study Design<\/jats:title>\n            <jats:p>A retrospective study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Neurological deficits occur in 1\/3 of spinal infection cases. Non-specific symptoms can lead to delays in diagnosis. This study reviews outcomes and the timeliness of diagnosis in patients with spinal infection who sustained subsequent spinal cord impairment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting<\/jats:title>\n            <jats:p>All 40 patients admitted to The Princess Royal Spinal Injuries Centre, Sheffield, UK, between 2016\u20132018 for rehabilitation for spinal cord impairment secondary to spinal infection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The average age was 58.6 years (31\u201385; SD 13.1) with 24 (60%) being male. 36 (90%) had native infections and 3 (7.5%) were acquired post-operatively (1 (2.5%) unknown). 7 patients had been intravenous drug users (17.5%). 50% (20) had previously sought medical attention for the same symptoms. There were long intervals to suspected diagnosis and to MRI (range 0\u201330 days). 15 (37.5%) patients deteriorated neurologically following admission to hospital; 8 were taking antibiotics at the time of deterioration. None of the patients had normal C-reactive protein levels at presentation. 7 (17.5%) sustained complete spinal cord impairment. 27 (67.5%) were discharged as wheelchair users.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Whilst the majority of patients responded to rehabilitation interventions, they were left with residual life changing disabilities. Among those requiring rehabilitation, delays in diagnosis appear to frequently occur pre-hospital. This could be attributed to a low index of suspicion in the community. Some deteriorated neurologically despite antibiotics. Close neurological monitoring of those suspected or confirmed to have a diagnosis of spinal infection is appropriate. There should be a low threshold for the use of inflammatory markers when investigating back pain.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41394-025-00706-0","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T18:04:12Z","timestamp":1744999452000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic delays in infective discitis \u2013 an unresolved problem"],"prefix":"10.1038","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1238-2627","authenticated-orcid":false,"given":"Lisa","family":"Grandidge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tokunbo","family":"Ogunleye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Thackray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Thumbikat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"706_CR1","doi-asserted-by":"publisher","first-page":"2787","DOI":"10.1007\/s00586-013-2850-1","volume":"22","author":"RM Duarte","year":"2013","unstructured":"Duarte RM, Vaccaro AR. Spinal infection: state of the art and management algorithm. Eur Spine J. 2013;22:2787\u201399.","journal-title":"Eur Spine J"},{"key":"706_CR2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jos.2017.09.016","volume":"23","author":"H Nagashima","year":"2018","unstructured":"Nagashima H, Tanishima S, Tanida A. Diagnosis and management of spinal infections. J Orthop Sci. 2018;23:8\u201313.","journal-title":"J Orthop Sci"},{"key":"706_CR3","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.2106\/JBJS.RVW.17.00104","volume":"6","author":"K Shenoy","year":"2018","unstructured":"Shenoy K, Singla A, Krystal JD, Razi AE, Kim YH, Sharan AD. Discitis in adults. JBJS Rev. 2018;6:e6.","journal-title":"JBJS Rev"},{"key":"706_CR4","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1093\/bmb\/ldw003","volume":"117","author":"E Nickerson","year":"2016","unstructured":"Nickerson E, Sinha R. Vertebral osteomyelitis in adults: an update. 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Ethics approval and patient consent was not required for this study. Health Research Authority (HRA) decision tool was completed and identified this project was not research. Approval was obtained from the Clinical Effectiveness Unit of Sheffield Teaching Hospitals NHS Foundation Trust.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Patient consent was not required for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}],"article-number":"10"}}