{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:35:22Z","timestamp":1788867322989,"version":"build-2803163510"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aim of this study was to determine differences between patients who underwent surgical treatment and those who underwent nonsurgical treatment of vertebral osteomyelitis (VO) and to identify potential factors influencing treatment failure (death and\/or recurrence within 1 year).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of clinical data prospectively collected from patients treated for VO between 2008 and 2020. The decision between surgical and nonsurgical treatment was made for each patient based on defined criteria. A 1:1 propensity score matching was performed to exclude confounders between the 2 treatments. Univariate and multivariable analyses were performed to identify potential risk factors for death and\/or recurrence within the first year after VO diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty-two patients (11.8%) were treated nonsurgically and 313 patients (88.2%) underwent surgery. A higher percentage of the surgically treated patients than the nonsurgically treated patients had an American Society of Anesthesiologists score of &gt;2 (69.0% versus 47.5%; p = 0.007), and the thoracic spine was affected more often in the surgical group (30.4% versus 11.9%; p = 0.013). Endocarditis was detected significantly more often in the nonsurgically treated patients (14.3% versus 4.2%; p = 0.018). The recurrence rate was 3 times higher in the nonsurgically treated patients (16.7% versus 5.4%; p = 0.017), but this difference was no longer detectable after propensity matching. After matching, the nonsurgically treated patients showed an almost 7-fold higher 1-year mortality rate (25.0% versus 3.7%; p = 0.018) and an almost 3-fold higher rate of treatment failure (42.9% versus 14.8%; p = 0.022). Multivariable analysis revealed nonsurgical treatment and bacteremia to be independent risk factors for treatment failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In our matched cohort of patients with VO, surgical intervention resulted in a significantly lower rate of treatment failure (death and\/or recurrence within 1 year) compared with nonsurgical intervention. Furthermore, nonsurgical treatment was an independent risk factor for treatment failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.23.00283","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T14:02:17Z","timestamp":1703858537000},"page":"575-581","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Surgery for Vertebral Osteomyelitis Lowers 1-Year Mortality and Failure Rates Compared with Nonsurgical Treatment"],"prefix":"10.2106","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8540-5725","authenticated-orcid":false,"given":"Nikolaus","family":"Kernich","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8865-8795","authenticated-orcid":false,"given":"Krishnan","family":"Sircar","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2048-7296","authenticated-orcid":false,"given":"Dorothee","family":"Jochimsen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6203-8616","authenticated-orcid":false,"given":"Sebastian Gottfried","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peer","family":"Eysel","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-0772","authenticated-orcid":false,"given":"Norma","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1723-5995","authenticated-orcid":false,"given":"Ayla","family":"Yagdiran","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8490-5549","authenticated-orcid":false,"given":"Carolyn","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"issue":"6","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1016\/j.spinee.2015.02.021","article-title":"Increased short- and long-term mortality among patients with infectious spondylodiscitis compared with a reference population","volume":"15","author":"Kehrer","year":"2015","journal-title":"Spine 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Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study","volume":"40","author":"Habib","year":"2019","journal-title":"Eur Heart J."},{"issue":"2","key":"bib26-20250430","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1007\/s10143-021-01640-z","article-title":"Spontaneous spondylodiscitis and endocarditis: interdisciplinary experience from a tertiary institutional case series and proposal of a treatment algorithm","volume":"45","author":"Viezens","year":"2022","journal-title":"Neurosurg Rev."},{"issue":"20","key":"bib27-20250430","doi-asserted-by":"crossref","first-page":"E607","DOI":"10.1097\/BRS.0000000000004420","article-title":"Treatment Failure in Vertebral Osteomyelitis: Is it All About Staphylococcus aureus?","volume":"47","author":"Yagdiran","year":"2022","journal-title":"Spine (Phila Pa 1976)."},{"issue":"3","key":"bib28-20250430","doi-asserted-by":"crossref","first-page":"e002412","DOI":"10.1136\/bmjopen-2012-002412","article-title":"Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database","volume":"3","author":"Akiyama","year":"2013","journal-title":"BMJ Open."},{"issue":"7","key":"bib29-20250430","doi-asserted-by":"crossref","first-page":"669.e9","DOI":"10.1016\/j.amjmed.2014.02.023","article-title":"The unique clinical features and outcome of infectious endocarditis and vertebral osteomyelitis co-infection","volume":"127","author":"Koslow","year":"2014","journal-title":"Am J Med."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.23.00283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:45:42Z","timestamp":1787751942000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.23.00283"}},"subtitle":["A Propensity-Matched Analysis"],"short-title":[],"issued":{"date-parts":[[2023,12,29]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.23.00283","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,29]]}}}