[Infectious spondylodiscitis]

Abstract

Vertebral osteomyelitis (VO) is an infection of the intervertebral disc with a possible extension to adjacent vertebrae. Annual incidence of VO in France is 2.4/100,000 inhabitants. It increases with age, above 6/100,000 over 70 years old. Eighty percent are hematogenous, and 20% developed after spinal surgery. The main unspecific symptoms are inflammatory spine pain, associated or not with fever. Diagnosis is performed with MRI, then blood cultures and disco-vertebral biopsy. The main causative organisms are staphylococci (40 to 60%), even though tuberculosis can be observed in 20%. Specific antimicrobial therapy, immobilisation and reeducation are needed. Clinical practice guidelines for management of infectious spondylodiscitis have been edited in 2007.