REGULAR CONTENT
Final ID
523
Type
Original Scientific Research-Oral or Pos
Authors
E Keshishian1, H Ajrawat1, K Massis1, C Davis1, G Hoots2, H Rojas1, A Kumar1, S Meader1
Institutions
1University of South Florida College of Medicine, Tampa, FL, 2N/A, Tampa, FL
Purpose
To evaluate the clinical utility of image-guided biopsy in vertebral osteomyelitis and how often it results in a change in management based on culture yield.
Materials & Methods
Retrospective cohort study on all consecutive patients that underwent an image-guided spinal biopsy for possible vertebral osteomyelitis from January 2010 to May 2015. We hypothesize that spinal biopsies do not provide significant additional information that impacts clinical management of patients with vertebral osteomyelitis.
Results
Of the 83 patients, only 12 (14%) cases resulted in a change in medical management. The culture yield was positive in 21 cases and only 10 (48%) resulted in a change in management. Regardless of culture results, patients were less likely to have a change in medical management with the difference being statistically significant favoring no change in management (OR 27.3; 95% CI 5.25-141.82; p<0.0001). The MRI (p=0.696) and CT (OR 0.194, 95% CI 0.024-1.534; p=0.315) imaging findings prior to biopsy were not statistically significant when correlating with a change in management. There was no statistically significant association between prior antibiotic exposure and culture yield (OR 1.439; 95% CI 0.531-3.902; p=0.645).
Conclusions
Vertebral biopsies have little clinical utility and do not lead to a significant change in management in the majority of cases. MR could be considered as an alternative to an invasive vertebral biopsy when coupled with clinical suspicion in patients with positive blood and/or urine cultures.
Final ID
523
Type
Original Scientific Research-Oral or Pos
Authors
E Keshishian1, H Ajrawat1, K Massis1, C Davis1, G Hoots2, H Rojas1, A Kumar1, S Meader1
Institutions
1University of South Florida College of Medicine, Tampa, FL, 2N/A, Tampa, FL
Purpose
To evaluate the clinical utility of image-guided biopsy in vertebral osteomyelitis and how often it results in a change in management based on culture yield.
Materials & Methods
Retrospective cohort study on all consecutive patients that underwent an image-guided spinal biopsy for possible vertebral osteomyelitis from January 2010 to May 2015. We hypothesize that spinal biopsies do not provide significant additional information that impacts clinical management of patients with vertebral osteomyelitis.
Results
Of the 83 patients, only 12 (14%) cases resulted in a change in medical management. The culture yield was positive in 21 cases and only 10 (48%) resulted in a change in management. Regardless of culture results, patients were less likely to have a change in medical management with the difference being statistically significant favoring no change in management (OR 27.3; 95% CI 5.25-141.82; p<0.0001). The MRI (p=0.696) and CT (OR 0.194, 95% CI 0.024-1.534; p=0.315) imaging findings prior to biopsy were not statistically significant when correlating with a change in management. There was no statistically significant association between prior antibiotic exposure and culture yield (OR 1.439; 95% CI 0.531-3.902; p=0.645).
Conclusions
Vertebral biopsies have little clinical utility and do not lead to a significant change in management in the majority of cases. MR could be considered as an alternative to an invasive vertebral biopsy when coupled with clinical suspicion in patients with positive blood and/or urine cultures.