Improving the organization of specialized care for patients with Non-specific pyogenic spinal infections

INTRODUCTION. Non-specific pyogenic spinal infections (NSPSI) are represented by such nosological forms of the disease as spondylitis, spondylodiscitis, epiduritis, or their various combinations, caused by nonspecific microflora. One of the reasons for the increase in the duration of the disease before treatment and the frequency of complicated forms is the lack of regulated routing of patients with NSPSI. The work analyzes the results of implementing the developed algorithm for diagnosis and tactics for nonspecific pyoinflammatory lesions of the spine, as well as the route regulatory orders of the Ministry of Health of the Sverdlovsk region based on it.

AIM. To improve the results of surgical treatment of patients with NSPSI by reducing the time required for diagnosing the disease and providing specialized neurosurgical care.

MATERIALS AND METHODS. A comparison was made of the treatment outcomes of two groups of patients: 1 – control (before the implementation of the algorithm and orders) 73 patients, 2 – research (after implementation of the proposed algorithm and orders) 338 patients. A comparative assessment of the duration of the disease, the initial neurological status according to the Frankel scale, the severity of the systemic inflammatory response syndrome and the results of surgical treatment in terms of the dynamics of the neurological status, the frequency of postoperative complications, and the presence of severe disability of patients was carried out.

RESULTS. In the comparison groups, there was an increase in the number of patients with a short duration of NSPSI (15–30 days) from 13.7 % in group 1 and to 34.9 % in group 2, and a reduction in the number of patients with long periods (more than 90 days) from 31.5 % in group 1 and up to 7.9 % in the main group (p<0.05). From the comparison results, it was proved that in group 2 of patients there was an increase in the number of good treatment outcomes up to 80.2% compared to group 1 (57.5 %), and a fourfold decrease in unsatisfactory treatment results from 20.6 to 4.4 % (p<0.05).

CONCLUSION. By introducing a diagnostic algorithm and tactics for non-specific pyogenic spinal infections, it was possible to improve the provision of medical care to patients in clinics and hospitals in the Sverdlovsk region, and to create a flow of patients to a specialized multidisciplinary hospital.

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