Abstract

The authors report their findings in a retrospective study of 151 cases of infectious spondylitis collected between 1970 and 2000. Diagnosis was based on bacteriological or pathological confirmation or on clinical, radiological and outcome arguments. Among 151 cases of infectious spondylitis diagnosed and treated, 110 were due to tuberculosis and 41 to other causes. There were 82 men and 69 women, with a mean age of 42 years. The delay from onset to diagnosis was 12 months. Risk factors were observed in 21% of the cases. The patients searched medical attention because of pain in 85% of cases. The leading causative agents in non tuberculous spondylitis were Staphylococcus aureus, followed by Brucella, and Salmonella, in this order. The diagnosis was considerably facilitated by the imaging techniques used; the most reliable technique was magnetic resonance imaging which improved diagnostic performance by detecting early, specific changes. A histo-bacteriological diagnosis was obtained by percutaneous transpedicular needle biopsy. Globally, 53% of the patients underwent needle biopsy, with a success rate of 62%, a figure comparable with those reported in other studies. In 35% of the patients, bacteriological confirmation of the infection was not obtained and diagnosis was founded on a set of clinical, biological and radiological data. Our results are similar to those described in the literature. However, in our country tuberculosis is the most frequent cause of infectious spondylodiscitis. Two populations are especially susceptible: the elderly and the immunodepressed. A specific diagnosis was obtained in 62% of the percutaneous transpedicular needle biopsy.