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Revista médica de Chile

versión impresa ISSN 0034-9887


FICA C, Alberto; BOZAN P, Francisca; ARISTEGUI V, Magdalena  y  BUSTOS G., Patricio. Spondylodiscitis, analysis of 25 cases. Rev. méd. Chile [online]. 2003, vol.131, n.5, pp.473-482. ISSN 0034-9887.

Background: Spondylodiscitis is a rare but prolonged inflammation of two adjacent vertebral bodies and the disk in between. Aim: To report the clinical features of a series of patients with spondylodiscitis. Material and methods: A retrospective analysis of medical records of patients with spondylitis, identified between 1989 and 2002. Results: A total of 25 cases were identified, 15 female, aged 49.8 years as a mean. Their mean evolution before admission was 4.3 months. Main complaints were back or radicular pain. Mild anemia was present in most patients. Mean erythrocyte sedimentation rate and C reactive protein values were 66 mm/h and 60 mg/L, respectively. Forty four percent of patients had neurological complications. Vertebral computed tomography and scintigraphic studies were done in 72% of patients, but magnetic resonance imaging was done only in 4 (16%). In 18 patients, a tissue sample for pathological and microbiological analysis, was obtained by imaging guiding or surgically. Tuberculosis, diagnosed on pathology, was the leading cause of spondylitis in nine cases (36%), followed by Staphylococcus aureus infection in five (20%). Other agents found were E coli and group D Streptococcus (one each). Age, symptoms, evolution time and different laboratory parameters did not differ between patients with tuberculosis and patients with other causes. A microbiological cause was not established in 36% of cases. Most patients evolved satisfactorily and recovered from neurological complications (88%). One patient with tuberculosis did not improve after prolonged treatment and 2 patients infected with S aureus died (8%). Conclusions: Spondylodiscitis is associated to a diversity of microbial agents and in most cases has a favorable prognosis (Rev Méd Chile 2003; 131: 473-82).

Palabras clave : Anti-infective agents, quinolones; Spondylitis; Staphylococcal infections.

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