RT Journal Article
SR Electronic
T1 Spondylodiscitis: A Retrospective Analysis of Clinical, Etiological, and Radiological Diagnosis
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 226
OP 231
DO 10.14444/7019
VO 14
IS 2
A1 AFONSO CARDOSO
A1 LUÍS BARBOSA
A1 ANA MARTA COELHO
A1 JOÃO GONÇALVES CORREIA
A1 HÉLDER LARGUINHO MAURÍCIO
A1 ÁLVARO LIMA
YR 2020
UL http://ijssurgery.com//content/14/2/226.abstract
AB Background: Spondylodiscitis is an uncommon disease, and due to its indolent nature, it is often a late diagnosis. Great stress is put on the etiologic diagnosis, but blood cultures do not always yield positive results. Magnetic resonance imaging (MRI), despite being the diagnostic method of choice, is not always available. Our aim was to characterize the clinical presentation and to identify and check the efficacy of the etiologic and radiological methods of diagnosis of spondylodiscitis used at our hospital.Methods: A retrospective study was conducted in which spontaneous spondylodiscitis cases were identified. The clinical presentation and the results of etiologic and radiological methods of diagnosis were analyzed.Results: Over a period of 5 years, 34 patients fulfilled the inclusion criteria of the study. Regarding days of complaints, we identified a median of 9.5 days (1–547 days), with back pain being the predominant symptom. Fever was present in half the patients. Blood cultures were positive in 16 patients (48.5%). Nineteen patients underwent a computed tomography (CT)–guided biopsy (positive in 7 patients [36.8%]), and 10 patients underwent a surgical biopsy (positive in half of them). Overall, 27 patients (79.4%) had an etiologic diagnosis. The diagnostic work-up consisted mostly of an initial CT scan followed by a confirmatory MRI. Of note, in 5 patients the CT scan did not reveal changes that were later confirmed by MRI. A total of 29 patients (85.3%) underwent an MRI, with 28 being diagnostic.Conclusions: Spondylodiscitis remain a difficult diagnosis. Blood cultures should always be obtained before antibiotic administration and a CT-guided or surgical biopsy should be done if needed. Our results confirm the importance of MRI as the imaging modality of choice and highlight the possibility of false-negative CT scans and the inability of CT to allow for a definitive diagnosis.