Current Diagnosis and Treatment of Spondylodiscitis

Abstract

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.

Treatment of spondylodiscitis

“…Observational studies have yielded a higher incidence of treatment failure when parenteral therapy was administered for less than four weeks [16,17]. In individual cases, the switch from parenteral to oral administration of antibiotics can be performed earlier, as soon as the patient's general condition has been reliably stabilised and the serum inflammatory markers have returned to normal or at least significantly improved [12]. The transfer to oral administration can also take place sooner if enteral bioavailability of the active ingredient is high, e.g.…”

“…If the patient requires urgent treatment due to sepsis or a fulminant disease course, empirical therapy with a broadspectrum antibiotic regimen appropriate to treat the most common pathogens for spondylodiscitis, i.e. Staphylococcus aureus and Escherichia coli, should be initiated only after collecting blood cultures [12]. Based on our experience, we suggest the following algorithm for collection of blood cultures, CT-guided biopsy, and intraoperative sampling ( Fig.…”

“…Immobilisation or fixation of the affected spine segments, antibiotic therapy, and, depending on the extent of the disease, debridement and decompression of the spinal canal are basic requirements for successful treatment yielding complete recovery from spondylodiscitis [12].…”

“…Based on our experience, we suggest the following algorithm for collection of blood cultures, CT-guided biopsy, and intraoperative sampling ( Fig. 1) [12,15].…”

“…The incidence of spondylodiscitis varies in developed countries between 1:100,000 and 1:250,000 [1,2,[9][10][11]. It is the main manifestation of haematogenous osteomyelitis in patients aged over 50 years and represents around 3-5% of all cases of osteomyelitis [12].…”