Risk factors and clinical characteristics of spondylodiscitis: a comparative study.

PURPOSE: Spondylodiscitis is a serious infection of the intervertebral discs and vertebrae, with rising incidence. This study provides an updated evaluation by analyzing causative microorganisms in tuberculous (TS), brucellar (BS), and pyogenic spondylodiscitis (PS). Our findings offer contemporary data to enhance understanding and management of spondylodiscitis.

METHODS

This retrospective study included 109 adult patients diagnosed with spondylodiscitis between 2011 and 2021 at a tertiary research center. Patients were categorized into three groups based on the causative pathogen. Demographic data, clinical presentations, laboratory findings, radiological imaging, and microbiological results were analyzed.

RESULTS

Among 109 patients, 59 (54.1%) had PS, 33 (32%) BS, and 17 (15.5%) TS. The cohort included 65 males (59.6%) and 44 females (40.4%), with a mean age of 57.6 ± 13.8 years. Back pain was the most common symptom (85.3%). Night sweats were more prevalent in BS (p < 0.001), while weight loss was less frequent in PS (p < 0.05). Diabetes was more common in PS (p < 0.001). PS cases had higher inflammatory markers (p < 0.001). Blood culture positivity was 53.6% in BS and 53.8% in PS. Surgery with tissue sampling was performed in 62 cases (56.9%). S. aureus was the most frequent pathogen, followed by Brucella spp.

CONCLUSION

Spondylodiscitis requires a multidisciplinary diagnostic approach due to its variable clinical presentations. PS is characterized by elevated inflammatory markers and concurrent infectious foci, BS by endemic risk factors and systemic symptoms, and TS by prolonged symptoms and thoracic involvement.