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Review
. 2025 Sep;39(3):419-435.
doi: 10.1016/j.idc.2025.02.011. Epub 2025 Apr 8.

Pyogenic Vertebral Osteomyelitis

Michael W Henry  1 , James E Dowdell 3rd  2 , Andy O Miller  3
Affiliations
Review

Pyogenic Vertebral Osteomyelitis

Michael W Henry et al. Infect Dis Clin North Am. 2025 Sep.

Abstract

Vertebral osteomyelitis is a general term for a heterogenous group of spine infections involving the vertebral bone, intervertebral discs, and facet joints. These infections can often spread contiguously to adjacent paraspinal structures, including paravertebral muscles and the epidural space and frequently presents with nonspecific and indolent symptoms, which can delay diagnosis. Treatment can be arduous, requiring prolonged courses of antibiotics often combined with surgical debridement. This review focuses primarily on pyogenic vertebral osteomyelitis in adults, reviewing the pathophysiology, epidemiology, microbiology, diagnosis, and treatment of this infection.

Keywords: Discitis; Osteomyelitis; Spine infection; Spondylodiscitis; Staphylococcus aureus.

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Conflict of interest statement

Disclosures M.W. Henry has no conflicts to disclose. J.E. Dowdell is the deputy editor for Spine Deformity Journal, a reviewer for the International Journal of Spine Surgery, serves as a consultant for Stryker, Bioventus, Providence Medical, and Globus Medical, and serves as a consultant for and is an investor in BICMD. A.O. Miller is a board member and current president of the Musculoskeletal Infection Society, and a reviewer for the Journal of Bone and Joint Surgery, the Journal of Bone and Joint Infection, the HSS Journal, and Clinical Infectious Diseases.

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