A disease that is difficult to diagnose and treat: evaluation of 343 spondylodiscitis cases

Abstract

Objective Spondylodiscitis is an important clinical a problem requiring serious approaches. In this study, we sought to raise awareness by examining the epidemiology and laboratory, clinical, and radiological findings of spondylodiscitis, which sometimes has a delayed diagnosis and which can be difficult to treat. Methods In total, 343 patients with spondylodiscitis were included in the study. Results The patients were classified as having as pyogenic (n = 153, 44.6%), brucellar (n = 138, 40.2%), or tuberculous (n = 52, 15.2%) spondylodiscitis. Meanwhile, 281 patients underwent magnetic resonance imaging, 71 underwent computed tomography, and 17 underwent scintigraphy for diagnosis. The rates of involvement at more than two segments and paraspinal abscess were significantly higher in tuberculous spondylodiscitis. However, disc involvement was significantly more common in brucellar and pyogenic spondylodiscitis. Conclusion The incidence of spondylodiscitis has increased substantially, especially in the young population. The invasive procedures and high rate of culture negativity make the diagnosis difficult. Therefore, clinical and radiological findings are useful in the diagnosis of spondylodiscitis. Despite the high rate of culture negativity, every effort should be made to identify the causative organism using invasive methods.

MRI radiomics-based evaluation of tuberculous and brucella spondylitis

“…Although there are differences in MRI presentation between BS and TBS, misdiagnosis often occurs because there is minimal specificity in terms of intervertebral space alteration and paravertebral abscess size. 25 – 27 This lack of specificity was confirmed in the present study. in the BS vs TBS(+) and BS vs TBS(−) comparisons, the MRI label-based LR model demonstrated lower AUC, upper limit of 95% CI, specificity, sensitivity, and other indicators, compared with the radiomics label-based and joint label-based RF models.…”

Clinical phenotyping of spondylodiscitis and isolated spinal epidural empyema: a 20-year experience and cohort study

“…A paraspinal abscess was found in approximately 47% of SD cases with/without epidural empyema ( 26 , 27 , 35 , 49 , 50 ). However, Chae, H. J. et al found a psoas abscess in 65% of ISEE patients ( 45 ).…”

Patients with Spondylodiscitis following Chemoradiotherapy for Head and Neck Cancer in a Portuguese Cancer Hospital: A Case Report

“…Spondylodiscitis consists of an infection that starts within the vertebral endplates and spreads secondarily to the adjacent vertebral discs, typically manifesting in adults [ 6 ]. Spondylodiscitis differs from spondylitis, as the latter is an inflammatory condition, without any elements of infection [ 10 ].…”

“…Spondylodiscitis differs from spondylitis, as the latter is an inflammatory condition, without any elements of infection [ 10 ]. Furthermore, spondylodiscitis can be sub-classified as pyogenic, brucellar, or tuberculous in origin, often acting as an insidious infection that requires prolonged antimicrobial therapeutic measures for successful recovery [ 6 ].…”