Spondylodiscitis: Update on Diagnosis and Management

J Antimicrob Chemother. 2010 Nov;65 Suppl 3:iii11-24. doi: 10.1093/jac/dkq303.

Abstract

Spondylodiscitis, a term encompassing vertebral osteomyelitis, spondylitis and discitis, is the main manifestation of haematogenous osteomyelitis in patients aged over 50 years. Staphylococcus aureus is the predominant pathogen, accounting for about half of non-tuberculous cases. Diagnosis is difficult and often delayed or missed due to the rarity of the disease and the high frequency of low back pain in the general population. In this review of the published literature, we found no randomized trials on treatment and studies were too heterogeneous to allow comparison. Improvements in surgical and radiological techniques and the discovery of antimicrobial therapy have transformed the outlook for patients with this condition, but morbidity remains significant. Randomized trials are needed to assess optimal treatment duration, route of administration, and the role of combination therapy and newer agents.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / diagnosis*
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / epidemiology
  • Bacterial Infections / surgery
  • Bone and Bones / diagnostic imaging
  • Discitis / diagnosis*
  • Discitis / drug therapy*
  • Discitis / epidemiology
  • Discitis / surgery
  • Humans
  • Radiography
  • Randomized Controlled Trials as Topic
  • Staphylococcus aureus / isolation & purification

Substances

  • Anti-Bacterial Agents