[Infectious spondylodiscitis: a study of forty-one cases]

To characterize a series of patients with Infectious Spondylodiscitis (IS).

Retrospective analysis of all cases diagnosed between October of 1999 and April of 2006 in our hospital, by files review.

Forty one patients, mean age of 61.2 +- 15.1 years; 26 (63.4%) were male. Thirty two (78.0%) had predisposing conditions or associated diseases and 12 (29.3%) had epidemiological risk. The most frequent clinical manifestations were local pain (97.6%) and general complaints (51.2%). The mean duration of the symptoms was 12.5 weeks. Raised erythrocyte sedimentation rate was the most frequent inflammatory marker. CT-scan was diagnostic in 3 cases and MRI in the remainders. IS was most frequent in the lumbar spine. The etiological agent was isolated in 22 patients (53.7 %) and in 4 (9.8%) the diagnosis was serological. The diagnosis of Pyogenic Spondylodiscitis (PS) was presumed in 21 (51.2%) cases, Granulomatous Spondylodiscitis (GS) in 18 (43.9%) and GS with pyogenic over infection in 2 (4.9%). Fourteen patients had other infectious foci. All patients had antibiotic treatment. Two patients needed abscess CT-scan guided drainage and five needed surgery. Twenty six patients (63.4%) had good evolution and 8 (19.5%) had reasonable evolution; 6 patients had bad evolution (14.6%), dying; one patient was lost for follow-up. Inflammatory markers decreased in the control analysis.

The IS is a diagnostic and therapeutic challenge, being the high index of suspicion of this pathology in the most susceptible patients fundamental for early detection and adequate treatment.