{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:43:01Z","timestamp":1787586181191,"version":"build-2736575974"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008750","name":"Shanghai Hospital Development Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008750","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>In this study, we aimed to analyze the pathogen detection results in spinal infections using percutaneous CT-guided biopsy or transforaminal endoscopic spinal biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective observational study of patients who underwent biopsy for spinal infection at Shanghai Sixth People\u2019s Hospital between December 2020 and June 2024. Data on demographics, clinical presentations, radiological findings, and histopathology were collected from medical records. Pathogen detection results from different sampling methods were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 131 cases of spinal infection were included in the study. The average age of the patients was 59.1\u202f\u00b1\u202f13.8\u202fyears. The median time from symptom onset to diagnosis was 2\u202fmonths [inter-quartile range (IQR): 1 to 4.5\u202fmonths]. Clinical manifestations included pain (100%) and fever (15.27%), with the lumbar vertebra being the most commonly affected site (110\/168, 65.48%). Elevated ESR, CRP, and IL-6 levels were observed in most cases. MR showed high sensitivity (90.90%) but low specificity (2.04%). Pathogen detection was performed using next-generation sequencing (mNGS) and\/or microbial culture. Of the 131 patients, 66 underwent percutaneous CT-guided biopsy, and 65 underwent transforaminal endoscopic spinal biopsy. All samples were tested using mNGS, while microbial culture was performed only on abscess samples from CT-guided biopsy cases. The most commonly identified pathogens were <jats:italic>Mycobacterium tuberculosis<\/jats:italic> (18.9), Staphylococcus (17.9), and Streptococcus (10.5). The positive detection rates using mNGS were 51.52% for percutaneous CT-guided biopsy and 50.77% for transforaminal endoscopic biopsy, whereas the culture-positive rates were 41.67 and 42.86% on abscess samples, respectively. There is no significant difference in the positive rates between the two biopsy techniques (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u202f=\u202f0.007292, <jats:italic>p<\/jats:italic>\u202f=\u202f0.9319). But the detection rate of Mycobacterium under CT-guided biopsy is higher (18.18% vs. 9.23%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Accurate pathogen diagnosis is crucial for the diagnosis and treatment of spinal infections. The microbiological detection rates of samples obtained via percutaneous CT-guided are similar to those obtained through transforaminal endoscopic spinal biopsy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1623598","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T04:10:48Z","timestamp":1755835848000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Percutaneous CT-guided or endoscopic spinal biopsy with accurate pathogen detection for spinal infection"],"prefix":"10.3389","volume":"16","author":[{"given":"Jinmei","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingxin","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luying","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leer","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Jiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Lian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohua","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.jinf.2009.02.006","article-title":"Diagnosis, management and outcome of clinically- suspected spinal infection","volume":"58","author":"Luzzati","year":"2009","journal-title":"J Infect"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2813","DOI":"10.2147\/IDR.S365757","article-title":"Clinical application and evaluation of metagenomic next-generation sequencing in pulmonary infection with pleural effusion","volume":"15","author":"Xu","year":"2022","journal-title":"Infect Drug Resist"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1016\/j.spinee.2021.04.001","article-title":"Responsiveness of routine diagnostic tests for vertebral osteomyelitis may be influenced by the infecting organism","volume":"21","author":"Ghassibi","year":"2021","journal-title":"Spine J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"703","DOI":"10.14444\/5088","article-title":"Vertebral osteomyelitis: a comparison of associated outcomes in early versus delayed surgical treatment","volume":"12","author":"Segreto","year":"2018","journal-title":"Int J Spine Surg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"875","DOI":"10.3238\/arztebl.2017.0875","article-title":"Spondylodiscitis: diagnosis and treatment options","volume":"114","author":"Herren","year":"2017","journal-title":"Dtsch Arztebl Int"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"499","DOI":"10.2214\/AJR.22.28423","article-title":"Image-guided biopsy in acute diskitis-osteomyelitis: a systematic review and Meta-analysis","volume":"220","author":"Chang","year":"2023","journal-title":"AJR Am J Roentgenol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"123","DOI":"10.2214\/AJR.14.13545","article-title":"Is Biopsying the paravertebral soft tissue as effective as Biopsying the disk or vertebral endplate? 10-year retrospective review of CT-guided biopsy of diskitis-osteomyelitis","volume":"205","author":"Chang","year":"2015","journal-title":"AJR Am J Roentgenol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"511","DOI":"10.2214\/AJR.22.28652","article-title":"Editorial comment: biopsy for diskitis-osteomyelitis-the path to maximum sensitivity","volume":"220","author":"Tuite","year":"2023","journal-title":"AJR Am J Roentgenol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e1179","DOI":"10.1016\/j.wneu.2022.05.123","article-title":"Percutaneous Transforaminal endoscopic debridement and drainage with accurate pathogen detection for infectious spondylitis of the thoracolumbar and lumbar spine","volume":"164","author":"Chen","year":"2022","journal-title":"World Neurosurg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"25870","DOI":"10.1038\/s41598-024-76887-9","article-title":"Analysis of the prevalence characteristics and risk factors of pulmonary tuberculosis combined with extrapulmonary tuberculosis in elderly patients","volume":"14","author":"Niu","year":"2024","journal-title":"Sci Rep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.ijid.2021.12.335","article-title":"mNGS for identifying pathogens in febrile neutropenic children with hematological diseases","volume":"116","author":"Guo","year":"2022","journal-title":"Int J Infect Dis"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"967584","DOI":"10.3389\/fcimb.2022.967584","article-title":"Evaluation of the metagenomic next-generation sequencing performance in pathogenic detection in patients with spinal infection","volume":"12","author":"Zhang","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1093\/cid\/cix881","article-title":"Understanding the promises and hurdles of metagenomic next-generation sequencing as a diagnostic tool for infectious diseases","volume":"66","author":"Simner","year":"2018","journal-title":"Clin Infect Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"5201","DOI":"10.2174\/0929867328666201222125225","article-title":"Current study of medicinal chemistry for treating spinal tuberculosis","volume":"28","author":"Wang","year":"2021","journal-title":"Curr Med Chem"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1623598\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T04:10:49Z","timestamp":1755835849000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1623598\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,22]]},"references-count":14,"alternative-id":["10.3389\/fneur.2025.1623598"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1623598","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,22]]},"article-number":"1623598"}}