{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:46:58Z","timestamp":1787503618080,"version":"build-2736575974"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Older populations have been increasing recently, resulting in an increase in cases of pyogenic spondylitis. Neurosurgeons who frequently treat the elderly are at a higher risk of encountering this condition. Therefore, this article provides a summary of the literature and our experience to help neurosurgeons effectively manage pyogenic osteomyelitis. It is important not to rule out pyogenic spondylosis when examining a patient with back pain, even in the absence of a fever. This is because the chronic type is common, easily overlooked, and early diagnosis and treatment are crucial. Empirical antibiotics should be avoided in cases where blood culture and biopsy are negative, to prevent microbial resistance and an increase in difficult-to-treat cases. Biopsies, such as computed tomography-guided percutaneous biopsy and full endoscopic debridement and drainage, should be attempted. Currently, 6 weeks of parenteral antibiotic therapy is the main treatment for pyogenic spondylitis. Surgical treatment is recommended if this method is ineffective. However, in the early stages, full endoscopic debridement and drainage and percutaneous pedicle screw fixation are optional.<\/jats:p>","DOI":"10.1055\/s-0043-1777272","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T18:56:27Z","timestamp":1703876187000},"page":"724-733","source":"Crossref","is-referenced-by-count":7,"title":["A Comprehensive Review of Pyogenic Spondylitis Management for Neurosurgeons"],"prefix":"10.1055","volume":"18","author":[{"given":"Masatoshi","family":"Yunoki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagawa Rosai Hospital, Marugame, Kagaw, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"ref1","first-page":"201","article-title":"Spondylodiscitis: is really all well defined?","volume":"23","author":"E Marchionni","year":"2019","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.surneu.2004.11.034","article-title":"Spondylodiscitis: diagnosis and treatment","volume":"64","author":"S Asamoto","year":"2005","journal-title":"Surg Neurol"},{"key":"ref3","first-page":"343","article-title":"Pyogenic osteomyelitis of the spine, an analysis and discussion of 102 cases","volume":"18","author":"J Kulowski","year":"1936","journal-title":"J Bone Joint Surg Br"},{"key":"ref4","first-page":"29","article-title":"Pyogenic osteomyelitis of the spine","volume":"28","author":"J Puig Guri","year":"1946","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"83","DOI":"10.2739\/kurumemedj.MS653001","article-title":"Pyogenic spondylitis: clinical features, diagnosis and treatment","volume":"65","author":"K Sato","year":"2019","journal-title":"Kurume Med J"},{"issue":"06","key":"ref6","first-page":"1171","article-title":"MR imaging of infectious spondylitis","volume":"11","author":"A Thrush","year":"1990","journal-title":"AJNR Am J Neuroradiol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3947\/ic.2021.0054","article-title":"Microbiologic diagnosis of pyogenic spondylitis","volume":"53","author":"N J Kim","year":"2021","journal-title":"Infect Chemother"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s00264-011-1384-6","article-title":"Pyogenic spondylitis","volume":"36","author":"W Y Cheung","year":"2012","journal-title":"Int Orthop"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.nec.2006.05.003","article-title":"Vertebral osteomyelitis","volume":"17","author":"J J Jaramillo-de la Torre","year":"2006","journal-title":"Neurosurg Clin N Am"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1097\/BRS.0b013e3181cff4f6","article-title":"Infective spondylitis in Southern Chinese: a descriptive and comparative study of ninety-one cases","volume":"35","author":"D KH Yee","year":"2010","journal-title":"Spine"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"e8905","DOI":"10.5812\/jjm.8905","article-title":"The prevalence, etiologic agents and risk factors for urinary tract infection among spinal cord injury patients","volume":"7","author":"T Togan","year":"2014","journal-title":"Jundishapur J Microbiol"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"476","DOI":"10.3390\/microorganisms8040476","article-title":"Spinal infections: an update","volume":"8","author":"A G Tsantes","year":"2020","journal-title":"Microorganisms"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s00264-011-1425-1","article-title":"Treatment of spondylodiscitis","volume":"36","author":"K Zarghooni","year":"2012","journal-title":"Int Orthop"},{"issue":"07","key":"ref14","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1007\/s00586-010-1358-1","article-title":"Existence of pyogenic spondylitis in Modic type 1 change without other signs of infection: 2-year follow-up","volume":"19","author":"S Ohtori","year":"2010","journal-title":"Eur Spine J"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jiph.2010.01.001","article-title":"Pyogenic spondylodiscitis: an overview","volume":"3","author":"G S Skaf","year":"2010","journal-title":"J Infect Public Health"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1302\/0301-620X.53B3.383","article-title":"Pyogenic infection of the spine. 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