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Updated: Jun 26, 2025
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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
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Spondylodiscitis: A Diagnostic and Management Dilemma
Akhshay J George1, Srinivasalu Santhanagopal1, Madan M Mohan1
1Orthopaedics, St. Johns Medical College Hospital, Bangalore, IND.
Cureus
|May 16, 2024
Summary
Accurate diagnosis of spondylodiscitis (SpD) requires correlating clinical and MRI findings with histopathology and microbiology. While HPE is more sensitive, GeneXpert improves microbial detection, though some cases remain non-specific.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Radiology
- Pathology
Background:
- Spondylodiscitis (SpD) is a serious spinal infection requiring prompt diagnosis and treatment.
- Accurate etiological diagnosis is crucial for effective antimicrobial therapy in SpD.
Purpose of the Study:
- To evaluate the correlation between clinical and MRI findings with histopathology (HPE) and microbiology (MB) in spondylodiscitis.
- To assess the diagnostic yield of HPE and MB in identifying the cause of SpD.
Main Methods:
- Prospective study of 34 patients with clinically diagnosed SpD.
- Image-guided or surgical biopsy for HPE and MB analysis.
- Inclusion of GeneXpert technique for improved microbial detection.
Main Results:
- 71% of patients showed findings consistent with infective SpD on HPE and MB.
- Combined HPE and MB confirmed etiology in 82.4% of cases.
- HPE demonstrated higher sensitivity than traditional MB; GeneXpert improved detection, especially for tuberculous SpD.
Conclusions:
- Determining the etiology of SpD remains challenging for targeted antimicrobial therapy.
- A systematic approach involving clinical suspicion, imaging, and tissue biopsy for HPE and MB is recommended.
- A subset of 'Non-specific' SpD cases will require empiric treatment based on clinico-radiologic profiles.
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