Description
The presentation led by James Walkden provides an in-depth overview of spinal infections, focusing on clinical implications, epidemiology, types of infections, diagnosis, and management. Beginning with a brief introduction and initial recognition of the collection of orthopedic surgeons present, Walkden emphasizes the significance of attributing proper risk factors and classification to spinal infections, such as discitis and spondylitis. He outlines the epidemiological data, highlighting that spinal infections occur in 0.2 to 2 per 10,000 hospital admissions, with increasing incidence in specific patient demographics, like the immunocompromised.
A key point in his discussion involves identifying sources of infection and pathophysiological mechanisms through Batson's plexus and contiguity from adjacent infections. Walkden notes the paramount importance of early recognition through clinical symptoms, including back pain, fever, and neurological deficits, and underscores how imaging plays a critical role in diagnosis, with MRI being the gold standard.
He also navigates the complexities of managing these infections, presenting controversies surrounding antibiotic therapies, surgical intervention, and the challenges posed by legal implications of delayed diagnosis or mismanagement. Throughout the talk, he asserts a cautious approach towards empirical treatment, the importance of meticulous documentation, and the nature of individual patient cases in guiding management decisions. The session closes with an engaging Q&A, fostering discussion among attendees about modern practices in the treatment of spinal infections.