Spondylodiscitis is a combination of

discitis Discitis, or diskitis, is an infection in the intervertebral disc space that affects different age groups. In adults, it can lead to severe consequences, such as sepsis or epidural abscess, but it can also spontaneously resolve, especially in chi ...

(

inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...

of one or more intervertebral disc spaces) and

spondylitis Spondylitis is an inflammation of the vertebrae. It is a form of spondylopathy. In many cases, spondylitis involves one or more vertebral joints, as well, which itself is called spondylarthritis. __TOC__ Types Pott disease is a tuberculous di ...

(inflammation of one or more

vertebrae The spinal column, a defining synapomorphy shared by nearly all vertebrates, Hagfish are believed to have secondarily lost their spinal column is a moderately flexible series of vertebrae (singular vertebra), each constituting a characteristi ...

), the latter generally involving the areas adjacent to the intervertebral disc space.

Causes

Spondylodiscitis is the most common complication of

sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is foll ...

or local infection, usually in the form of an abscess. The main causative organisms are

staphylococci ''Staphylococcus'' is a genus of Gram-positive bacteria in the family Staphylococcaceae from the order Bacillales. Under the microscope, they appear spherical ( cocci), and form in grape-like clusters. ''Staphylococcus'' species are facultativ ...

, but potential organisms include a large number of bacteria, fungi, zoonoses. Spondylodiscitis frequently develops in

immunocompromised Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that a ...

individuals, such as by a cancer, infection, or by

immunosuppressive drug Immunosuppressive drugs, also known as immunosuppressive agents, immunosuppressants and antirejection medications, are drugs that inhibit or prevent activity of the immune system. Classification Immunosuppressive drugs can be classified into ...

s used for organ transplantations.

Diagnosis

The main methods to diagnose a spondylodiscitis are magnetic resonance imaging (MRI), biopsy and microbiological tests such as

PCR PCR or pcr may refer to: Science * Phosphocreatine, a phosphorylated creatine molecule * Principal component regression, a statistical technique Medicine * Polymerase chain reaction ** COVID-19 testing, often performed using the polymerase chain r ...

to determine an infectious cause.

Treatment

Approximately 90% of cases can be treated conservatively. In the absence of spinal cord/nerve root compression and lack of data on instability of the inflamed segment, conservative treatment with: * Antibiotics - empirical treatment should start AFTER biopsy material for microbiological testing is obtained (PMID: 27082590). The following empirical treatment may be administered for a total of 6 weeks (PMID: 26872859): - Ceftriaxone 2x2g and Clindamycin 3x600mg i.v. for 2 weeks - Ciprofloxacin 2x500mg and Clindamycin 4x300mg p.o. for 4 more weeks If the pathogen can be identified - antibiotic treatment should be adapted to the susceptibilities of the microorganism. * Bed rest

References

External links

{{Dorsopathies Vertebral column disorders