Spondylodiscitis – known and unknown

Authors: P. Polák 1;  E. Pernicová 1;  P. Husa 1;  Š. Bohatá 2;  A. Štouračová 2
Authors‘ workplace: Klinika infekčních chorob FN a LF MU Brno Přednosta: prof. MUDr. Petr Husa, CSc. 1;  Radiologická klinika FN a LF MU Brno Přednosta: prof. MUDr. Vlastimil Válek, CSc., MBA 2
Published in: Prakt. Lék. 2010; 90(9): 519-524
Category: Various Specialization


The infection of intervertebral disc and of the vertebral body is a disease associated with relatively high mortality and with a risk of severe long-lasting complications. Immobile and immunocompromised patients with metabolic complications represent the majority of predisposed persons. It is distinguished among spondylodiscitis of

– bacterial,

– fungal and

– parasitic origin.

Tuberculosis represents specific form of spondylodiscitis.

The diagnosis is often difficult – multiple diagnostic procedures have to be combined. The most sensitive and specific method is magnetic-resonance-imaging (MRI). The therapy of spondylodiscitis has to respect specifics of antibiotic pharmacokinetics into the bone tissue and has to be always elongated. At present, there exist no worldwide unified guidelines. In this article recent knowledge of aetiology, pathophysiology, diagnosis and therapy of spondylodiscitis are reviewed.

The aim of this article is to enhance medical staff awareness of this condition.

Key words:

spondylodiscitis, infection, pharmacotherapy.


1. Acosta, F.L. Jr., Galvez, L.F., Aryan, H.E. Recent advances: infections of the spine. Curr. Inf. Dis. Reports 2006, 8, p. 390-393.

2. Bettini, N., Girardo, C.M., Dema, C.E. Evaluation of conservative treatment of non specific spondylodiscitis. Eur. Spine J. 2009,18, p. 143-150.

3. Butler, J.S., Shelly, M.J., Timlin, M. et al. Nontuberculous pyogenic spinal infection in adults. Spine 2006, 31(23), p. 2695-2700.

4. Cottle, L., Riordan, T. Infectious spondylodiscitis. J. Inf. 2008, 56, p. 401-412.

5. Darley, E.S.R., MacGowan, A.P. Antibiotic treatment of gram-positive bone and joint infections. J. Antimicrob. Chemother. 2004, 53, p. 928-935.

6. del Pozo, J.S.G., Soto, M.V., Solera, J. Vertebral osteomyelitis: long-term disability assessment and prognostic factors. J. Inf. 2007, 54, p. 129-134.

7. Ewald, C., Gartemann, J., Kuhn, S.A. et al. Operative Therapie der bakteriellen Spondylodiszitis – eine retrospektive Untersuchung. Orthopäde, 2009, 38, s. 248-255.

8. Gaudias, J. Considerations on antimicrobial therapy for pyogenic discitis. Joint Bone Spine 2001, 68, p. 463-465.

9. Grados, F., Lescure, F.X., Senneville, E. Suggestions for managing pyogenic (non-tuberculous) discitis in adults. Joint Bone Spine 2007, 74, p. 133-139.

10. Hadjipavlou, A.G., Mader, J.T., Necessary, J.T. et al. Hematogenous pyogenic spinal infections and their surgical management. Spine 2000, 25(13), p. 1668-1679.

11. Hof, H., Schilling, F. Diskussion zu dem Beitrag: Aktuelle Diagnostik und Therapie der Spondylodiszitis. Dtsch. Aerzteblatt 2008, 105(39), s. 674.

12. Kapsalaki, E., Gatselis, N., Stefos, A. et al. Spontaneous spondylodiscitis: presentation, risk factors, diagnosis, management, and outcomes. Int. J. Inf. Dis. 2009, 13, p. 564-569.

13. Khan, I.A., Vaccaro, A.R., Zlotolow, D.A. Management of vertebral diskitis and osteomyelitis. Orthopedics 1999, 22(8), p. 758-765.

14. Legrand, E., Flipo, R.-M., Guggenbuhl, P. et al. Management of nontuberculous infectious discitis. Treatments used in 110 patients admitted to 12 teaching hospitals in France. Joint Bone Spine 2001, 68, p. 504-509.

15. Müller, E.J., Russe, O.J., Muhr, G. Osteomyelitis der Wirbelsäule. Orthopäde, 2004, 33, s. 305-315.

16. Sobottke, R., Seifert, H., Fätkenheuer, G., et al. Aktuelle Diagnostik un Therapie der Spondylodiszitis. Dtsch. Aerzteblatt, 2008, 105(10), s. 181-187.

17. Société de pathologie infectieuse de langue francaise. Recommandations pour la pratique clinique: spondylodiscites infectieuses primitives, et secondaires à un geste intradiscal, sans mise en place de materiel. Med et mal infectieuses, 2007, 37, p. 573-583.

18. Wirtz, D.Ch., Genius, I., Wildberger, J.E. et al. Diagnostic and therapeutic management of lumbar and thoracic spondylodiscitis – an evaluation of 59 cases. Arch. Orthop. Traum. Surg. 2000, 120, p. 245-251.

19. Zeller, V., Desplaces, N. Antibiothérapie des infections osteoarticulaires à pyogènes chez l´adulte: principes et modalités. Rev du Rhumatisme, 2006; 3, p. 183-190.

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