A diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis: a retrospective...

Area of Science:

• Orthopedics
• Infectious Diseases
• Radiology

Background:

• Spinal infections, including tuberculous spondylitis (TS) and pyogenic spondylitis (PS), present diagnostic challenges.
• Accurate differentiation is crucial for effective treatment and patient outcomes.

Purpose of the Study:

• To compare clinical, laboratory, and imaging findings between TS and PS.
• To develop and validate a diagnostic model for distinguishing between these two conditions.

Main Methods:

• Retrospective analysis of 112 patients diagnosed with TS or PS.
• Comparison of clinical data, laboratory results (WBC, ESR, CRP, etc.), and imaging findings (abscesses, vertebral involvement, compression).
• Binary logistic regression used to construct a diagnostic model, validated with an external group.

Main Results:

• Significant differences observed in age, laboratory markers (WBC, ESR, CRP, FIB, albumin, sodium), and imaging features (epidural/paravertebral abscesses, spinal cord compression, vertebral site involvement).
• A diagnostic model was constructed incorporating variables like thoracic/cervical vertebrae involvement, paravertebral abscesses, spinal cord compression, serum albumin, ESR, and fibrinogen.
• The model demonstrated effectiveness in distinguishing TS from PS in the validation group.

Conclusions:

• A novel diagnostic model for differentiating tuberculous spondylitis and pyogenic spondylitis has been developed.
• The model integrates clinical, laboratory, and imaging data, offering potential guiding value for diagnosing spinal infections.
• This tool provides a valuable reference for clinical decision-making in managing spinal infections.