LAUSR

Background Early microbiological diagnosis and multidisciplinary management are the main predictive factor for successful treatment in septic spondylitis. However, the therapeutic management of spondylodiscitis without bacteriological diagnosis is not well codified. Objectives To evaluate whether there is clinical, biological or significant imaging between patients with infectious sondylodiscitis as they had or not a microbiological diagnosis. Methods Retrospective study including 107 patients hospitalized in our department between 1999 and 2018. The diagnosis was based on clinical, biological, radiological and bacteriological data. Results This study involved 107 patients, including 58 men (54.2%) and 49 women (45.8%) with a mean age of 55 years [16–86]. Spinal pain was observed in all cases and the lumbar spine was most affected (54.2%). A neurological deficit was noted in 16.82% of cases. The inflammatory syndrome was present in 90.6% of cases. Radiographs of the spine were abnormal in 83.1% of cases. CT and Spinal MRI were performed respectively in 60% and 78.8% of cases. Disco vertebral biopsy was performed in 73 patients and was contributory in 46.5% of cases. We divided patients into two groups: patients with a confirmed biological diagnosis (group 1: 45.3%) versus patients in whom the diagnosis had been held on presumptive criteria (group2: 54.2%). There was no statically significant difference in the age (p=0.5), sex (p=0.3), risk factors such as diabetes (p=0.8), the start mode (p= 0.4), the presence of an impaired general condition (p=0.3), night sweats (p=0.1) and a neurological deficit (p=0.8), biological parameters (p=0.3) and the occurrence of complications (p=0.09) between the two groups. Vertebral condensation in radiographs of the spine was higher in group 2 and this was statically significant (p=0.03). In addition, the consumption of unpasteurized milk and positivity of wright serology was higher in the first group (p= 0.001 and p<0.001; respectively). Similarly, contributive histological result of vertebral biopsy was more frequent in group 1 (p=0.007). Conclusion Diagnosing infectious spondylodiscitis is facilitated by improved access to MRI testing. However, microbiological diagnosis is the main key to a successful management of this life threatening infection. Disclosure of Interests:  None declared