Current diagnosis and treatment of spondylodiscitis.
BACKGROUND
Infection of the spinal column is rare, and often recognized and treated too late. Spondylodiscitis is osteomyelitis of the spine and can cause severe symptoms. Hospital mortality is in the region of 2% to 17%.


METHODS
Selective literature review and results of the authors' own research.


RESULTS
The incidence of pyogenic spondylodiscitis is around 1 : 250 000, which represents around 3% to 5% of osteomyelitis as a whole. 10% to 15% of all vertebral infections can be ascribed to exogenous spondylodiscitis, with Staphylococcus aureus as the commonest pathogen, 2% to 16% of which are reported to be MRSA (methicillin-resistant S. aureus). Catheter-related, nosocomial infection with MRSA is a key cause for spondylodiscitis. 50% of all skeletal tuberculoses are found in the spine.


CONCLUSIONS
Spondylodiscitis should be borne in mind in cases of diffuse back pain and non-specific symptoms. MRI is the diagnostic modality of choice for detecting spondylodiscitis. Thanks to precise monitoring of conservative treatments and primarily stable surgical techniques, prolonged immobilization of the patient is no longer necessary nowadays.
Sobottke
Rolf
R
Klinik und Poliklinik für Orthopädie der Universität zu Köln, Joseph-Stelzmann-Strasse 9, Köln, Germany. sobottke@gmx.de
Seifert
Harald
H
Fätkenheuer
Gerd
G
Schmidt
Matthias
M
Gossmann
Axel
A
Eysel
Peer
P