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The application of endoscopic debridement combined with metagenomic next-generation sequencing technology in primary spinal infections: a retrospective study.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101265112 Publication Model: Electronic Cited Medium: Internet ISSN: 1749-799X (Electronic) Linking ISSN: 1749799X NLM ISO Abbreviation: J Orthop Surg Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, 2006-
    • Subject Terms:
    • Abstract:
      Purpose: Spinal endoscopy is a novel minimally invasive spinal surgery technique used in recent years to treat various degenerative spinal diseases. Metagenomic next-generation sequencing (mNGS) is a new method for identifying infectious microorganisms in infectious diseases. We aim to evaluate the application effect of combining spinal endoscopy with mNGS in diagnosing and treating spinal infections.
      Methods: The clinical data of 62 patients with suspected spinal infectious diseases admitted from January 2020 to December 2023 were retrospectively analyzed. All patients underwent spinal endoscopy to obtain tissue specimens, histopathological examination, routine bacterial culture, and mNGS sequencing. Describe the pathogenic microbial spectrum of spinal infection, and compare the differences in sensitivity (true positive rate) and specificity (true negative rate) between the two detection methods. White blood cell (WBC) erythrocyte deposition rate (ESR), C-reactive protein (CRP), visual analog scale (VAS), Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI), and other clinical results were analyzed.
      Results: In 62 cases, mNGS, microbiological culture, serologic testing, and pathologic examination results were obtained. 49 cases of spinal infections and 13 cases of non-spinal infections were finally diagnosed clinically. Among the 49 patients with spinal infections, there were 31 cases of purulent bacterial infections, 8 cases of tuberculosis infections, and 10 cases of infections with unspecified etiological microorganisms. Among the 13 cases of non-spinal infections, there were 3 cases of spinal tumors, 6 cases of Modic changes of the endplates, and 4 cases of endplate fracture. The positive rate of microbial culture was 36.73% (18/49), and the positive rate of the mNGS test was 71.43% (35/49), which was statistically different from each other (P < 0.01). The sensitivity of the mNGS test was 71.43%, and the specificity of the mNGS test was 84.62%. At the 3-month follow-up, WBC, ESR, and CRP levels were normalized. The VAS, JOA score, and ODI of the lower back and legs at each follow-up point after surgery were significantly improved compared with those before surgery, and the difference was statistically significant (P < 0.01).
      Conclusion: Metagenomic sequencing technology is fast, efficient, and accurate in detecting pathogenic microorganisms, and has high diagnostic value in the diagnosis and treatment of spinal infections. Spinal endoscopic debridement combined with mNGS can achieve good clinical results.
      Competing Interests: Declarations. Ethics approval and consent to participate: Patients’ informed consent was obtained (Ethics Committee of Ningbo No. 2 Hospital, Ref. No. YJ-NBEY-KYSB-2024-100-12). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
      (© 2024. The Author(s).)
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    • Grant Information:
      2024HMZD05 the Key Research Foundation of Ningbo No.2 Hospital; 2024021 Zhejiang provincial key clinical specialty; 2022-F15 the project of Ningbo leading medical & Health Discipline; 2023HMJQ03 the Distinguished Young Scholars of Ningbo No.2 Hospital
    • Contributed Indexing:
      Keywords: Etiological diagnosis; Metagenomic next-generation sequencing; Spinal endoscopy; Spinal infection
    • Publication Date:
      Date Created: 20250226 Date Completed: 20250308 Latest Revision: 20250308
    • Publication Date:
      20250309
    • Accession Number:
      PMC11852877
    • Accession Number:
      10.1186/s13018-024-05385-5
    • Accession Number:
      40001114