[Clinical characteristics of spinal cord injury caused by infection]. / Características clínicas de la lesión medular de causa infecciosa.

INTRODUCTION: Infections account for 3% of all non-traumatic spinal cord injuries. The demographic distribution and clinical course are still not fully understood in these patients. AIMS: The aim of this study was to determine the clinical-epidemiological characteristics and clinical course in patients with infectious spinal cord injury referred to our centre. PATIENTS AND METHODS: A retrospective study (over the period 1997-2003) was carried out. Variables examined included age, sex, type of injury, aetiology, causing agent, ASIA classification on admission and discharge. RESULTS: N = 27 (8% of the total number of non-traumatic spinal cord injuries). Mean age: 37.3 years (range: 14-75). Higher prevalence was found between the ages of 20 and 39 years (48.1%) and in males (70.4%). A prevalence of dorsal injuries (59.3%) was also observed. On hospital admission most of the injuries were incomplete (70.4%) and this figure increased to 77.8% on discharge. Spondylodiscitis was the most frequent cause (51.9%) and Staphylococcus aureus was found to be the most common microbiological causing agent. The greatest prevalence of complete injuries was observed in cases of dorsal injuries (43.75%). All cases of tuberculosis were situated in the dorsal region (p < 0.05). CONCLUSIONS: In our care centre, non-traumatic spinal cord injuries of an infectious origin seem to be most often caused by spondylodiscitis due to S. aureus, with a higher incidence in the dorsal region. They predominantly affect males in their thirties and forties, and usually give rise to incomplete injuries.

Lesión medular de causa osteoarticular / Spinal cord injury due to osteoarticular causes

Introducción. La lesión medular es una de las discapacidades más trágicas, debido a sus secuelas. La incidencia varía entre 9 y 53 lesionados por millón de habitantes. Las lesiones por causa no traumática suponen un número significativo de casos, pero no se han estudiado bien. Nuestro objetivo fue el estudio descriptivo de las lesiones medulares no traumáticas, de tipo osteoarticular, en nuestro centro. Pacientes y métodos. Se realizó un estudio retrospectivo de las historias clínicas de los pacientes remitidos a nuestro centro por lesión medular no traumática, degenerativa, en el período comprendido entre 1998 y 2002. Evaluamos la edad, el sexo, la clasificación de la lesión neurológica según la ASIA (American Spinal Injury Association) en el momento del ingreso y en el del alta, la afectación completa (motora y sensitivo) o incompleta, el nivel de la lesión y la causa que la provoca. Resultados. Encontramos 365 historias de pacientes con lesión medular no traumática. De ellos, 45 (12,3%) correspondían a lesiones de tipo osteoarticular. El grupo de edad y la causa más frecuente fueron 56-69 años y estenosis de canal, respectivamente. Se observó un predominio del sexo masculino y de lesión incompleta. El nivel neurológico más afectado fue el cervical. Conclusión. En nuestro centro, la lesión medular no traumática de causa osteoarticular se produce predominantemente por estenosis de canal, con mayor incidencia cervical. Se produce preferiblemente en varones de 56-69 años y suele dar lugar a lesiones incompletas. Dichos datos se correlacionan con los observados por otros autores (AU)

Introduction. Spinal cord injury is one of the most tragic disabilities, because of its sequelae. Incidence ranges between 9 and 53 cases per million inhabitants. Injuries due to non-traumatic causes account for a significant number of cases but they have not been studied in depth. Our objective was to conduct a descriptive study of osteoarticular-type nontraumatic spinal cord injuries in our centre. Patients and methods.We carried out a retrospective study of the medical records of patients referred to our centre because of non-traumatic, degenerative spinal cord injury between 1998 and 2002. We evaluated age, sex, neurological injury classification according to the ASIA (American Spinal Injury Association) on admission and on discharge, complete (motor and sensory) or incomplete involvement, level of the injury and how it was caused. Results. We found 365 records of patients with non-traumatic spinal injuries, 45 (12.3%) of which were osteoarticular- type injuries. The age group and most frequent cause were 56-69 years and canal stenosis, respectively. There was seen to be a predominance of males and incomplete injury. The neurological level that was most affected was the cervical spine. Conclusions. In our centre, the majority of cases of non-traumatic spinal cord injury due to osteoarticular causes are produced by canal stenosis, with a greater incidence in the cervical spine. It is more often observed in 56 to 69-year-old males and usually involves incomplete injuries. Such data match those obtained by other authors (AU)

Características clínicas de la lesión medular de causa infecciosa / Clinical characteristics of spinal cord injury caused by infection

Introducción. La etiología infecciosa representa el 3% de la lesión medular no traumática. La distribución demográfica y evolución clínica no son completamente conocidas en estos pacientes. Objetivos. Conocer las características clinicoepidemiológicas y la evolución en pacientes con lesión medular infecciosa remitidos a nuestro centro. Pacientes y métodos. Estudio retrospectivo (período 1997-2003). Variables: edad, sexo, tipo de lesión, etiología, agente causal, clasificación ASIA al ingreso y al alta. Resultados. N = 27 (8% del total de lesiones medulares no traumáticas). Edad media: 37,3 años (rango: 14-75). Mayor prevalencia en edades comprendidas entre 20 y 39 años (48,1%) y en varones (70,4%). Se observa una mayor prevalencia de lesiones dorsales (59,3%). Al ingreso la mayoría de lesiones fueron incompletas (70,4%), y aumentaron hasta un 77,8% al alta. La espondilodiscitis fue la causa más frecuente (51,9%), y el Staphylococcus aureus, el agente microbiológico etiológico más frecuente. La mayor prevalencia de lesiones completas se observa en lesiones dorsales (43,75%). El 100% de los casos de tuberculosis asentaron en la región dorsal (p < 0,05). Conclusiones. En nuestro centro, la lesión medular de causa no traumática de etiología infecciosa parece estar producida en mayor frecuencia por espondilodiscitis por S. aureus, con una mayor incidencia en la región dorsal. Afecta predominantemente a varones en la tercera y cuarta décadas de la vida y suele producir lesiones incompletas (AU)

Introduction. Infections account for 3% of all non-traumatic spinal cord injuries. The demographic distribution and clinical course are still not fully understood in these patients. Aims. The aim of this study was to determine the clinicalepidemiological characteristics and clinical course in patients with infectious spinal cord injury referred to our centre. Patients and methods. A retrospective study (over the period 1997-2003) was carried out. Variables examined included age, sex, type of injury, aetiology, causing agent, ASIA classification on admission and discharge. Results. N = 27 (8% of the total number of nontraumatic spinal cord injuries). Mean age: 37.3 years (range: 14-75). Higher prevalence was found between the ages of 20 and 39 years (48.1%) and in males (70.4%). A prevalence of dorsal injuries (59.3%) was also observed. On hospital admission most of the injuries were incomplete (70.4%) and this figure increased to 77.8% on discharge. Spondylodiscitis was the most frequent cause (51.9%) and Staphylococcus aureus was found to be the most common microbiological causing agent. The greatest prevalence of complete injuries was observed in cases of dorsal injuries (43.75%). All cases of tuberculosis were situated in the dorsal region (p < 0.05). Conclusions. In our care centre, non-traumatic spinal cord injuries of an infectious origin seem to be most often caused by spondylodiscitis due to S. aureus, with a higher incidence in the dorsal region. They predominantly affect males in their thirties and forties, and usually give rise to incomplete injuries (AU)

[Spinal cord injury due to osteoarticular causes]. / Lesión medular de causa osteoarticular.

INTRODUCTION: Spinal cord injury is one of the most tragic disabilities, because of its sequelae. Incidence ranges between 9 and 53 cases per million inhabitants. Injuries due to non-traumatic causes account for a significant number of cases but they have not been studied in depth. Our objective was to conduct a descriptive study of osteoarticular-type non-traumatic spinal cord injuries in our centre. PATIENTS AND METHODS: We carried out a retrospective study of the medical records of patients referred to our centre because of non-traumatic, degenerative spinal cord injury between 1998 and 2002. We evaluated age, sex, neurological injury classification according to the ASIA (American Spinal Injury Association) on admission and on discharge, complete (motor and sensory) or incomplete involvement, level of the injury and how it was caused. RESULTS: We found 365 records of patients with non-traumatic spinal injuries, 45 (12.3%) of which were osteoarticular-type injuries. The age group and most frequent cause were 56-69 years and canal stenosis, respectively. There was seen to be a predominance of males and incomplete injury. The neurological level that was most affected was the cervical spine. CONCLUSIONS: In our centre, the majority of cases of non-traumatic spinal cord injury due to osteoarticular causes are produced by canal stenosis, with a greater incidence in the cervical spine. It is more often observed in 56 to 69-year-old males and usually involves incomplete injuries. Such data match those obtained by other authors.