Clinical Features and Treatment Differences Among Tuberculous, Brucellosis, and Pyogenic Spondylitis: A Cohort Study

Area of Science:

• Infectious Diseases
• Orthopedics
• Clinical Medicine

Background:

• Spinal infections, including tuberculous spondylitis (TBS), brucellosis spondylitis (BS), and pyogenic spondylitis (PS), present a growing clinical challenge.
• Understanding the distinct clinical characteristics and treatment outcomes of different spondylitis types is crucial for effective patient management.

Purpose of the Study:

• To compare the clinical features and treatment strategies for tuberculous spondylitis, brucellosis spondylitis, and pyogenic spondylitis.
• To provide clinical guidance for the timely diagnosis and treatment of various spinal infections.

Main Methods:

• A retrospective analysis of 125 patients with spinal infections treated between October 2019 and December 2024.
• Classification of patients into tuberculous spondylitis (TBS), brucellosis spondylitis (BS), or pyogenic spondylitis (PS) groups.
• Statistical comparison of clinical characteristics, treatment regimens, and outcomes using SPSS and GraphPad Prism software.

Main Results:

• Pyogenic spondylitis (PS) cases showed a shorter duration from symptom onset to hospitalization and were associated with sepsis and multi-vertebral involvement.
• Fever and pain were more common in BS and PS compared to TBS.
• Treatment durations varied significantly: 77 weeks for TBS, 19 weeks for BS, and 13 weeks for PS. Omadacycline and contezolid demonstrated efficacy.

Conclusions:

• Spinal infections exhibit diverse clinical presentations and risk factors, necessitating individualized treatment approaches.
• Long treatment courses require vigilant monitoring for adverse drug reactions (ADRs).
• Omadacycline and contezolid are effective and safe options for managing spinal infections.