title: [Current treatment strategies for spondylodiscitis in surgical clinics in Germany].
abstract: BACKGROUND
  Spondylodiscitis is a rare disease which is associated with high mortality. No guidelines for treatment exist and the available studies are not homogeneous. Attempts have been made in recent years to structure therapy using algorithms. Early recognition of the disease is above all important for its later outcome. Therapy takes place in not only orthopaedic/trauma surgery clinics but also in neurosurgical clinics.
  
  
  METHODS
  We sent an online survey on this subject to orthopaedic clinics, trauma surgery and neurosurgery clinics in Germany. The aim was to ascertain current care strategies in Germany. A further objective was to elicit differences between the specialist fields.
  
  
  RESULTS
  A total of 164 clinics responded to the survey. The response rate was 16% of the orthopaedic/trauma surgery clinics and 32% of the neurosurgical clinics. Differences between the two specialist fields can be found particularly in the use of systemic and local antibiotics, in the choice of surgical access to the thoracic spine and the lumbar spine and in post-operative imaging. In both specialist fields, patients with neurological dysfunctions are treated primarily in clinics with high case numbers. In terms of surgery, 2/3 of the responding clinics choose a one-stage operative treatment. Minimally invasive procedures and the use of cages are widespread. The participants estimate that, on the whole, a better outcome and higher patient satisfaction tend to exist after operative treatment.
  
  
  CONCLUSIONS
  The lack of homogeneity regarding treatment strategies which is indicated here clearly shows the need for therapy guidelines as an aid to orientation. This will be a challenge for the future due to the low incidence and the situation regarding currently available studies.
authors.affiliation: Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: V
authors.initials: V
authors.lastname: Quack
authors.affiliation: Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: I
authors.initials: I
authors.lastname: Hermann
authors.affiliation: Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: B
authors.initials: B
authors.lastname: Rath
authors.affiliation: Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: K
authors.initials: K
authors.lastname: Dietrich
authors.affiliation: Klinik für Neurochirurgie, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: C
authors.initials: C
authors.lastname: Spreckelsen
authors.affiliation: Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: C
authors.initials: C
authors.lastname: Lüring
authors.affiliation: Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: D
authors.initials: D
authors.lastname: Arbab
authors.affiliation: Institut für medizinische Informatik, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: C-A
authors.initials: CA
authors.lastname: Mueller
authors.affiliation: Klinik für Wirbelsäulenchirurgie, Zentralklinik Bad Berka.
authors.forename: M
authors.initials: M
authors.lastname: Shousha
authors.affiliation: Institut für medizinische Informatik, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: H
authors.initials: H
authors.lastname: Clusmann
authors.affiliation: Klinik für Orthopädie, RWTH Aachen, Universitätsklinikum Aachen.
authors.forename: M
authors.initials: M
authors.lastname: Tingart
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015299:Discitis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005858:Germany; D019538:Health Care Surveys; D006782:Hospitals, Special; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D019637:Orthopedic Procedures; D009985:Orthopedics; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D019919:Prosthesis Implantation; D013904:Thoracic Vertebrae / Q000601:surgery; D014194:Traumatology
chemical_list: D000900:Anti-Bacterial Agents