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Updated: Apr 9, 2026
Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
A narrative review of our developing knowledge about paediatric spondylodiscitis based on existing literature
Ahmer Ahmad Khan1,2,3, Aikaterini Doubovina4, Giacomo De Marco2
1Department of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Insights
Paediatric spondylodiscitis (SD) is a spinal infection in children under 16. High-throughput sequencing of plasma offers a promising, less invasive method for diagnosing this challenging condition.
Area of Science:
- Pediatric infectious diseases
- Spinal infections
- Diagnostic microbiology
Background:
- Pediatric spondylodiscitis (SD) involves vertebral bodies and discs in children under 16.
- It can spread to adjacent areas, causing complications like abscesses and meningitis.
- Current diagnostic methods like blood cultures and biopsies have limited yields.
Purpose of the Study:
- To explore advanced diagnostic techniques for pediatric spondylodiscitis.
- To highlight the potential of liquid biopsy in identifying pathogens in pediatric SD.
- To discuss the microbiological landscape and treatment approaches for pediatric SD.
Main Methods:
- Review of current literature on pediatric spondylodiscitis diagnosis and treatment.
- Discussion of nucleic acid amplification tests (NAATs) for pathogen identification.
- Exploration of high-throughput sequencing (HTS) on plasma samples as a liquid biopsy approach.
Main Results:
- Kingella kingae and Staphylococcus aureus are key pathogens in pediatric SD, varying by age.
- High-throughput sequencing of plasma shows promise for detecting pathogens in focal infections.
- Disc sampling is often discouraged in pediatric SD, making non-invasive methods crucial.
Conclusions:
- Advanced molecular techniques, particularly HTS on plasma, represent a significant advancement for diagnosing pediatric SD.
- Accurate pathogen identification is vital for guiding appropriate medical treatment, which is the mainstay of care.
- Further research into liquid biopsy applications could revolutionize pediatric spinal infection diagnostics.
Abstract:
Paediatric spondylodiscitis (SD) is an infection involving the vertebral bodies and adjacent intervertebral discs in populations below 16 years old. It is rarely confined to a single compartment; more often, it spreads to other areas in the spinal column and may cause other infections, such as epidural abscesses, subdural abscesses, septic arthritis of the facet joints, paravertebral abscesses and even meningitis. SD predominantly affects children from 6 to 48 months old, and the lumbar spine seems to be most at risk; no specific markers are currently available for a biological diagnosis of SD. Blood cultures are often negative, and even disc or bone biopsies show limited yields. However, recent advances in nucleic acid amplification tests have laid the foundations for developing and implementing more efficient methods of identifying pathogens in samples. Microbiologically, Kingella kingae dominates in children from 6 to 48 months old, while Staphylococcus aureus is more common in infants under 6 months and in older children. High-throughput sequencing performed on plasma samples (recognised as liquid biopsy) is a promising multi-purpose tool that can detect not only pathogens circulating in the bloodstream but also those emanating from focal infections, something particularly interesting in cases of paediatric SD, where disc sampling is strongly discouraged. Paediatric SD treatments are mainly medical; surgery is rarely indicated, except for abscess drainage, emergency neurological decompression or spinal stabilisation.
