2008Deutsches Ärzteblatt internationalOpen access

Current Diagnosis and Treatment of Spondylodiscitis

Rolf Sobottke, Harald Seifert, Gerd Fätkenheuer, Matthias Schmidt, Axel Goßmann, Peer Eysel

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Abstract

INTRODUCTION: Infection of the spinal column is rare, and often recognized and treated too late. Spondylodiscitis is osteomyelitis of the spine and can cause severe symptoms. Hospital mortality is in the region of 2% to 17%. METHODS: Selective literature review and results of the authors' own research. RESULTS: The incidence of pyogenic spondylodiscitis is around 1 : 250 000, which represents around 3% to 5% of osteomyelitis as a whole. 10% to 15% of all vertebral infections can be ascribed to exogenous spondylodiscitis, with Staphylococcus aureus as the commonest pathogen, 2% to 16% of which are reported to be MRSA (methicillin-resistant S. aureus). Catheter-related, nosocomial infection with MRSA is a key cause for spondylodiscitis. 50% of all skeletal tuberculoses are found in the spine. DISCUSSION: Spondylodiscitis should be borne in mind in cases of diffuse back pain and non-specific symptoms. MRI is the diagnostic modality of choice for detecting spondylodiscitis. Thanks to precise monitoring of conservative treatments and primarily stable surgical techniques, prolonged immobilization of the patient is no longer necessary nowadays.

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INTRODUCTION: Infection of the spinal column is rare, and often recognized and treated too late. Spondylodiscitis is osteomyelitis of the spine and can cause severe symptoms. Hospital mortality is in the region of 2% to 17%. METHODS: Selective literature review and results of the authors' own research. RESULTS: The incidence of pyogenic spondylodiscitis is around 1 : 250 000, which represents around 3% to 5% of osteomyelitis as a whole. 10% to 15% of all vertebral infections can be ascribed to exogenous spondylodiscitis, with Staphylococcus aureus as the commonest pathogen, 2% to 16% of which are reported to be MRSA (methicillin-resistant S. aureus). Catheter-related, nosocomial infection with MRSA is a key cause for spondylodiscitis. 50% of all skeletal tuberculoses are found in the spine. DISCUSSION: Spondylodiscitis should be borne in mind in cases of diffuse back pain and non-specific symptoms. MRI is the diagnostic modality of choice for detecting spondylodiscitis. Thanks to precise monitoring of conservative treatments and primarily stable surgical techniques, prolonged immobilization of the patient is no longer necessary nowadays.

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Available abstract

INTRODUCTION: Infection of the spinal column is rare, and often recognized and treated too late. Spondylodiscitis is osteomyelitis of the spine and can cause severe symptoms. Hospital mortality is in the region of 2% to 17%. METHODS: Selective literature review and results of the authors' own research. RESULTS: The incidence of pyogenic spondylodiscitis is around 1 : 250 000, which represents around 3% to 5% of osteomyelitis as a whole. 10% to 15% of all vertebral infections can be ascribed to exogenous spondylodiscitis, with Staphylococcus aureus as the commonest pathogen, 2% to 16% of which are reported to be MRSA (methicillin-resistant S. aureus). Catheter-related, nosocomial infection with MRSA is a key cause for spondylodiscitis. 50% of all skeletal tuberculoses are found in the spine. DISCUSSION: Spondylodiscitis should be borne in mind in cases of diffuse back pain and non-specific symptoms. MRI is the diagnostic modality of choice for detecting spondylodiscitis. Thanks to precise monitoring of conservative treatments and primarily stable surgical techniques, prolonged immobilization of the patient is no longer necessary nowadays.

Key concepts: Spondylodiscitis, Medicine, Vertebral osteomyelitis, Osteomyelitis, Discitis, Spondylitis, Incidence (geometry), Surgery

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