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[Infectious spondylitis--diagnosis and therapy]

C Beyeler1

  • 1Rheumatologische Universitätsklinik, Inselspital, Bern.

Therapeutische Umschau. Revue Therapeutique
|June 1, 1994
PubMed
Summary

Spinal infections, often pyogenic osteomyelitis, present with pain and systemic symptoms, diagnosed via MRI. Treatment involves targeted antibiotics, with surgery for complications like neurological deficits or severe bone destruction.

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Area of Science:

  • Spinal infections
  • Pyogenic osteomyelitis
  • Hematogenous seeding

Context:

  • Spinal infections typically manifest as pyogenic osteomyelitis, frequently arising from hematogenous spread of bacteria like Staphylococcus, Escherichia coli, or Pseudomonas.
  • Clinical presentation includes rest pain, constitutional symptoms, elevated erythrocyte sedimentation rate (ESR), and delayed radiographic evidence.

Purpose:

  • To outline the typical presentation, diagnostic modalities, and management strategies for spinal infections.
  • To highlight the role of Magnetic Resonance Imaging (MRI) as the preferred diagnostic tool.
  • To delineate indications for surgical intervention in spinal infections.

Summary:

  • Pyogenic spinal osteomyelitis commonly results from hematogenous bacterial seeding.
  • Diagnosis relies on clinical signs, elevated ESR, and advanced imaging, particularly MRI.
  • Treatment is tailored, involving antibiotics based on microbial sensitivity and surgical management for specific complications.

Impact:

  • Early and accurate diagnosis of spinal infections is crucial for effective management.
  • MRI provides superior visualization for diagnosing spinal osteomyelitis.
  • Appropriate antibiotic therapy and timely surgical intervention improve patient outcomes and prevent long-term sequelae.

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