title: Primary acquired spondylodiscitis shows a more severe course than spondylodiscitis following spine surgery: a single-center retrospective study of 159 cases.
abstract: Spondylodiscitis may arise primarily via hematogenous spread or direct inoculation of virulent organisms during spine surgery. To date, no comparative data investigating the differences between primary and postoperative spondylodiscitis is available. Thus, the purpose of this retrospective study was to investigate differences between these two etiologies. One hundred fifty-nine patients that were treated at our department were included in the retrospective analysis. The patients were categorized into two groups based on the etiology of spondylodiscitis: group NS, primary spondylodiscitis without prior spinal surgery; group S, spondylodiscitis following spinal surgery. Evaluation included magnetic resonance imaging (MRI), laboratory values, clinical outcome, and operative or conservative management. Preoperative MRI showed higher rates of epidural and paraspinal abscess in patients with primary spondylodiscitis (p < 0.005). Vertebral bone destruction was more severe in group NS (p < 0.05). Survival rate in group S (98.2%) was higher than in group NS (87.5%, p = 0.024). The extent of the operative procedure in patients who were surgically treated (n = 116) differed between the two groups (p < 0.005). In conclusion, spondylodiscitis is a life-threatening and serious disease and requires long-term treatment. Primary spondylodiscitis is frequently associated with epidural and paraspinal abscess, vertebral bone destruction and has a higher mortality rate than postoperative spondylodiscitis. Therefore, primary spondylodiscitis shows a more severe course than spondylodiscitis following spine surgery.
authors.affiliation: Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria. anja.tschugg@i-med.ac.at.
authors.forename: Anja
authors.initials: A
authors.lastname: Tschugg
authors.affiliation: Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
authors.forename: Sara
authors.initials: S
authors.lastname: Lener
authors.affiliation: Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Hartmann
authors.affiliation: Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rietzler
authors.affiliation: Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Neururer
authors.affiliation: Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
authors.forename: Claudius
authors.initials: C
authors.lastname: Thomé
mesh_terms: D000328:Adult; D000368:Aged; D015299:Discitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D004824:Epidural Space; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D012189:Retrospective Studies; D013131:Spine / Q000601:surgery*; D016896:Treatment Outcome
keywords: Discitis; Epidural abscess; Postoperative spondylodiscitis; Primary spondylodiscitis; Spinal infection