Long-term sequelae in patients with spondylodiscitis: independent predictors

To identify independent predictors of long-term sequelae in patients with infectious spondylodiscitis.

We conducted a retrospective cohort study including 215 patients hospitalized for infectious spondylodiscitis between 2010 and 2024. Clinical, biological, and radiological data were collected. Factors associated with long-term sequelae were analyzed using multivariate logistic regression.

Long-term sequelae occurred in 99 patients (46%). The most common sequelae were persistent back pain (34.9%), spinal deformity (14.9%), and radicular pain (6.5%). The prevalence of sequelae differed across etiological groups, with the highest frequency observed in tuberculous spondylodiscitis (p < 0.05). Patients with sequelae were younger (50 ± 17 vs 55 ± 17 years; p < 0.05) and more likely to present with constitutional symptoms, neurological deficit, elevated erythrocyte sedimentation rate (ESR), and radiological findings such as psoas abscesses, spinal epidural abscesses, and spinal cord compression. On multivariate analysis, younger age (adjusted odds ratio [aOR]=0.97 per year increase; p < 0.01), elevated ESR (aOR=1.012 per mm/h; p < 0.01), neurological deficit (aOR=2.72; p <0.01), psoas abscess (aOR=5.27; p<0.001), and spinal epidural abscess (aOR=2.40; p < 0.05) were independently associated with long-term sequelae.

Infectious spondylodiscitis is associated with a high rate of long-term sequelae. Younger age, neurological deficit, elevated ESR, and specific radiological findings, particularly psoas and spinal epidural abscesses, were independent predictors of sequelae. Early identification of high-risk patients may help optimize management and improve outcomes.