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Vertebral osteomyelitis in adults: an update.
Emma K Nickerson1, Rohitashwa Sinha2
1Department of Infectious Diseases, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK emma.nickerson@addenbrookes.nhs.uk.
British Medical Bulletin
|February 14, 2016
Summary
Vertebral osteomyelitis diagnosis requires blood cultures and MRI. While surgery is increasingly favored for faster recovery, evidence for optimal medical and surgical management of this growing condition remains limited.
Area of Science:
- Spinal Infections
- Musculoskeletal Disorders
Background:
- Increasing incidence of vertebral osteomyelitis due to aging population and improved diagnostics.
- Vertebral osteomyelitis presents diagnostic and therapeutic challenges.
Purpose of the Study:
- To review current literature on vertebral osteomyelitis management.
- To identify areas of consensus and controversy in diagnosis and treatment.
Main Methods:
- Systematic literature search of PubMed database (2009-2014).
- Keywords: 'vertebral osteomyelitis', 'spondylodiscitis'.
- Inclusion criteria: English language publications.
Main Results:
- Blood cultures and MRI are essential for diagnosis.
- Surgical debridement is a primary treatment; use of instrumentation in active infection is increasing.
- Significant variation exists in biopsy techniques, antimicrobial strategies, and surgical timing.
Conclusions:
- Further research needed to optimize spinal biopsy techniques for etiology determination.
- High-quality trials are required to establish evidence-based guidelines for medical and surgical management.
- The role of conservative medical management as a default option needs further investigation.
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