Epidural Abscess in Routine Preoperative MRI Reports Versus Documented Operative Findings, and Exploratory Mortality Risk Factors in Surgically Treated Spondylodiscitis: A Retrospective Single-Centre Study
- 1Department of Orthopaedics and Traumatology, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, 34396 Istanbul, Türkiye
- 2Department of Orthopaedics and Traumatology, Esenyurt Necmi Kadıoğlu State Hospital, Esenyurt, 34517 Istanbul, Türkiye
- 3Department of Orthopaedics and Traumatology, Başakşehir Çam ve Sakura City Hospital, University of Health Sciences, Başakşehir, 34480 Istanbul, Türkiye
Abstract
Background: Surgical decisions in spondylodiscitis rely on the preoperative magnetic resonance imaging (MRI) report, and postoperative mortality remains high. We examined how often routine MRI reports described an epidural abscess later documented at surgery and explored factors associated with mortality. Methods: Twenty-seven adults operated on for pyogenic or fungal spondylodiscitis at one centre (2017–2025) were studied retrospectively. Findings were abstracted from routine MRI reports and operative notes, with epidural pus documented at surgery as the reference. Mortality was explored with univariable Cox and receiver operating characteristic analyses. Results: Epidural pus was documented in 11 patients; none of their MRI reports described an epidural abscess (sensitivity 0%, 95% confidence interval [CI] 0–28.5%), although six reported paraspinal soft-tissue involvement. Eleven patients (40.7%) died during a median follow-up of 2.5 months. Age (hazard ratio 1.14 per year, 95% CI 1.00–1.30) and the age-adjusted Charlson Comorbidity Index (1.54 per point, 1.05–2.28) were associated with mortality and discriminated similarly (areas under the curve 0.741 and 0.736); the unadjusted index and the Pola, Homagk, Spinal Instability Neoplastic Score, and Spinal Instability Spondylodiscitis Score classifications were not. Conclusions: In this small retrospective cohort, routine MRI reports named no epidural abscess among patients in whom one was documented at surgery. Mortality was associated with age and age-adjusted comorbidity burden. These exploratory findings require prospective validation.
Related
- Prognostic impact of the preoperative Naples prognostic score on overall and progression-free survival in surgically treated oral squamous cell carcinoma: A retrospective cohort study from a Taiwanese medical center.
- Preoperative triglyceride-glucose index and 30-day surgical site infection in OSCC patients without documented diabetes: a retrospective cohort study.
- Exploratory clinical predictors and internally validated models of in-hospital mortality after PCI in obese patients with acute myocardial infarction and documented cardiogenic shock: a single-center retrospective study.
- Documented preoperative statin exposure and short-term mortality after aortic valve replacement: a multicohort observational study
- Spondylodiscitis in a tuberculosis-endemic setting in Somalia: epidemiological, clinical, radiological, and outcome findings from a retrospective study
BibTeX
@article{balkanlı2026epidural,
title = {{Epidural Abscess in Routine Preoperative MRI Reports Versus Documented Operative Findings, and Exploratory Mortality Risk Factors in Surgically Treated Spondylodiscitis: A Retrospective Single-Centre Study}},
author = {Bahadır Balkanlı and Enver İpek and Mehmet Alp Yüksel and Oğuzhan Nayman and Yusuf Sülek and Mehmet Ali Talmaç},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197665},
url = {https://europepmc.org/article/PMC/PMC13666127},
note = {CC BY},
}
RIS
TY - JOUR
TI - Epidural Abscess in Routine Preoperative MRI Reports Versus Documented Operative Findings, and Exploratory Mortality Risk Factors in Surgically Treated Spondylodiscitis: A Retrospective Single-Centre Study
AU - Bahadır Balkanlı
AU - Enver İpek
AU - Mehmet Alp Yüksel
AU - Oğuzhan Nayman
AU - Yusuf Sülek
AU - Mehmet Ali Talmaç
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197665
UR - https://europepmc.org/article/PMC/PMC13666127
AB - Background: Surgical decisions in spondylodiscitis rely on the preoperative magnetic resonance imaging (MRI) report, and postoperative mortality remains high. We examined how often routine MRI reports described an epidural abscess later documented at surgery and explored factors associated with mortality. Methods: Twenty-seven adults operated on for pyogenic or fungal spondylodiscitis at one centre (2017–2025) were studied retrospectively. Findings were abstracted from routine MRI reports and operative notes, with epidural pus documented at surgery as the reference. Mortality was explored with univariable Cox and receiver operating characteristic analyses. Results: Epidural pus was documented in 11 patients; none of their MRI reports described an epidural abscess (sensitivity 0%, 95% confidence interval [CI] 0–28.5%), although six reported paraspinal soft-tissue involvement. Eleven patients (40.7%) died during a median follow-up of 2.5 months. Age (hazard ratio 1.14 per year, 95% CI 1.00–1.30) and the age-adjusted Charlson Comorbidity Index (1.54 per point, 1.05–2.28) were associated with mortality and discriminated similarly (areas under the curve 0.741 and 0.736); the unadjusted index and the Pola, Homagk, Spinal Instability Neoplastic Score, and Spinal Instability Spondylodiscitis Score classifications were not. Conclusions: In this small retrospective cohort, routine MRI reports named no epidural abscess among patients in whom one was documented at surgery. Mortality was associated with age and age-adjusted comorbidity burden. These exploratory findings require prospective validation.
SN - 2077-0383
ER -