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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
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Spondylodiscitis: Diagnosis and Treatment Options
Christian Herren1, Norma Jung, Miguel Pishnamaz
1Department for Trauma and Reconstructive Surgery, University Hospital RWTH Aachen; Department I for Internal Medicine, University Hospital Cologne; Center of Orthopedic and Trauma Surgery, University Hospital Cologne; Center for Orthopaedics and Trauma Surgery, Rhein-Maas Klinikum GmbH, Würselen.
Deutsches Arzteblatt International
|January 12, 2018
Summary
Spondylodiscitis diagnosis and treatment are crucial for patient outcomes, despite nonspecific symptoms. Early intervention improves quality of life, though persistent back pain and recurrence risks exist with comorbidities.
Area of Science:
- Spinal infections and inflammatory conditions.
Background:
- Spondylodiscitis incidence is rising globally.
- Nonspecific symptoms and absence of fever delay diagnosis and treatment.
- Early diagnosis and treatment are essential for optimal patient outcomes.
Purpose of the Study:
- To review current diagnostic and treatment strategies for spondylodiscitis.
- To highlight key findings from recent literature on spondylodiscitis management.
Main Methods:
- Systematic literature search of Medline and Cochrane Library (January 2009 - March 2017).
- Inclusion of 30 relevant publications from 788 identified articles.
Main Results:
- Magnetic resonance imaging (MRI) is the gold standard for diagnosis (92% sensitivity, 96% specificity).
- Staphylococcus aureus is the most common cause in Europe; tuberculosis worldwide.
- Antibiotic therapy is fundamental; surgery indicated for neurologic deficits, sepsis, or instability.
Conclusions:
- Appropriate treatment leads to generally satisfactory quality of life, with persistent back pain possible.
- Comorbidities like diabetes and renal failure increase recurrence risk.
- Undrained epidural abscesses are a significant risk factor for recurrence.
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