Red flags for the early detection of spinal infection in back pain patients

© 2019 The Author(s). Background: Red flags are signs and symptoms that are possible indicators of serious spinal pathology. There is limited evidence or guidance on how red flags should be used in practice. Due to the lack of robust evidence for many red flags their use has been questioned. The aim was to conduct a systematic review specifically reporting on studies that evaluated the diagnostic accuracy of red flags for Spinal Infection in patients with low back pain. Methods: Searches were carried out to identify the literature from inception to March 2019. The databases searched were Medline, CINHAL Plus, Web of Science, Embase, Cochrane, Pedro, OpenGrey and Grey Literature Report. Two reviewers screened article texts, one reviewer extracted data and details of each study, a second reviewer independently checked a random sample of the data extracted. Results: Forty papers met the eligibility criteria. A total of 2224 cases of spinal infection were identified, of which 1385 (62%) were men and 773 (38%) were women mean age of 55 (± 8) years. In total there were 46 items, 23 determinants and 23 clinical features. Spinal pain (72%) and fever (55%) were the most common clinical features, Diabetes (18%) and IV drug use (9%) were the most occurring determinants. MRI was the most used radiological test and Staphylococcus aureus (27%), Mycobacterium tuberculosis (12%) were the most common microorganisms detected in cases. Conclusion: The current evidence surrounding red flags for spinal infection remains small, it was not possible to assess the diagnostic accuracy of red flags for spinal infection, as such, a descriptive review reporting the characteristics of those presenting with spinal infection was carried out. In our review, spinal infection was common in those who had conditions associated with immunosuppression. Additionally, the most frequently reported clinical feature was the classic triad of spinal pain, fever and neurological dysfunction. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

Unusual occurrence of cervical myelopathy in a case of Stickler's syndrome.

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Contraception orale continue par D Norgestrel (30 gamma). Analyse des variations des taux des gonadotropines et des stéroïdes

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Progrès récents dans le traitement neurochirurgical des tumeurs intra-médullaires.

Magnetic resonance imaging (MRI) and cavitron ultrasonic surgical aspirator have strongly modified our surgical strategy in intramedullary spinal cord tumors. Our experience, based on 19 cases, has convinced us that radical removal of intramedullary spinal cord tumors may be accomplished without exacerbating neurological deficit in the majority of patients. The quality of results depends on the pre-operative neurological deterioration. No paraplegic patients have improved. All these tumors, even gliomas, may be removed so that radiotherapy has no more indication, but it is too early to claim that these patients are cured. Neurological and MRI follow-up is necessary during some years.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

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Temporal bone pseudofractures in children

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