Abstract
Spondylodiscitis is often the result of hematogenous seeding of the adjacent disc space from a distant focus and is the most common spinal infection. It is typically diagnosed in the setting of recalcitrant back pain unresponsive to conservative measures and elevated C-reactive protein with or without fever. The incidence has risen to 10 per 100,000 inhabitants per year in the western countries and is increasing due to the aging population, rise in the rate of immunosuppressed patients, and improvements in diagnostic possibilities. Spondylodiscitis is a life-threatening disease with a mortality rate of up to 20% in some cases. Although some therapeutic guidelines are available, treatment of spondylodiscitis is certainly not standardized and is mostly based on local preferences. Conservative treatment, comprising of antibiotics combined with bed rest and/or an orthosis, appears to be the treatment of choice for the majority of the patients with uncomplicated spondylodiscits. However, conservative treatment leads to healing of the inflammation in only 85% of cases. Reports of surgical studies demonstrate healing of the inflammation in almost all cases following spinal instrumentation. At this moment, there is insufficient high-quality data available to create a complete evidence-based guideline with strong recommendations for the treatment of pyogenic spondylodiscitis.
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Shiban, E., Meyer, B. (2020). Treatment Considerations for Pyogenic Spinal Infection. In: O'Brien, J., Kalantar, S., Drazin, D., Sandhu, F. (eds) The Resident's Guide to Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-20847-9_30
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