[Non-tubercular vertebral osteomyelitis: diagnosis and therapy of 45 patients from a single Italian centre].
OBJECTIVE
to evaluate the episodes of non-tubercular spondylodiskitis diagnosed between 1998 and 2002 at Ospedale S. Corona, Pietra Ligure (SV).


METHODS
prospective evaluation of vertebral osteomyelitis classified as spontaneous or iatrogenic if associated with procedures on the spinal cord, with detection of associated risk factors, localization, etiology and treatment.


RESULTS
45 episodes, 71% spontaneous and 29% iatrogenic were observed. Associated risk factors were present in 47% of spontaneous spondylodiskitis. Lumbosacral localization was detected in 68% of spontaneous and 100% of iatrogenic episodes. Other localizations in spontaneous spondylodiskitis were dorsal (25%) or cervical (7%). Methicillin-sensitive staphylococci caused the majority of spontaneous spondylodiskitis, while methicillin-resistant strains were more frequently involved in iatrogenic episodes. Among spontaneous spondylodiskitis, 63% healed with antibiotics for 8 weeks, but surgery was often needed in dorsal localizations. In iatrogenic forms antibacterial therapy for 8 weeks-6 months was effective in cases not associated with foreign bodies but their presence always required surgery for healing.


CONCLUSIONS
spondylodiskitis is more frequently localized at the lumbosacral level. Beta-lactams are generally effective in spontaneous episodes, while iatrogenic episodes often require associations of drugs. Surgery may be required in the case of dorsal localization or in the presence of foreign bodies.
Carrega
Giuliana
G
Azienda Ospedale "S. Corona" Pietra Ligure, Savona, Italy.
Arena
Sergio
S
Bartolacci
Valentina
V
Gavino
Dario
D
Mecca
Domenico
D
Sandrone
Clemente
C
Santoriello
Luisa
L
Tabasso
Giuseppe
G
Riccio
Giovanni
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D003131:Combined Modality Therapy; D015299:Discitis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology / Q000601:surgery; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D016268:Internal Fixators; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents