Spinal osteomyelitis: a review of 10 years' experience

Spinal osteomyelitis is an infrequent cause of back pain, but it can cause severe neurologic compromise or death if not treated effectively. We report 71 cases of spinal osteomyelitis. Ninety-three percent of patients complained of back pain that had been present for several weeks (average: 59 days) at the time of hospitalization. Localized tenderness and an elevated erythrocyte sedimentation rate were often the only abnormal signs. Plain radiographs were abnormal in 39 to 56 cases. At our institution, computed tomography-guided biopsy was safe and effective, yielding a pathogenic organism in 19 of 30 procedures vs 24 of 32 cultures of open surgical specimens.