LAUSR

Purpose There was an increasing incidence of spinal infections. This study aimed to compare and contrast the clinical characteristics and treatment regimens for diverse types of spondylitis and to provide guidance for clinicians to make timely diagnosis and treatment. Patients and Methods One hundred and twenty-five patients with spinal infections admitted to the First Affiliated Hospital of Anhui Medical University from October 2019 to December 2024 were recruited. The patients were classified as having tuberculous spondylitis (TBS), brucellosis spondylitis (BS), or pyogenic spondylitis (PS). The patient’s treatment regimen and course were dynamically followed up during hospitalization and after discharge. Comparisons of clinical characteristics and treatment among the three groups were performed by SPSS 26.0 and GraphPad Prism 10 statistical software. Results The proportion of male patients was greater than female patients (65.00% vs 35.00%). Fever accompanied by pain was more prevalent in the BS and PS groups than in the TBS group (P=0.003). Compared with the TBS and BS groups, the PS group had the shortest duration from symptom onset to hospitalization (P<0.001). Sepsis, invasive manipulation, elevated inflammatory markers, psoas abscesses, and the involvement of three or more vertebrae were significantly associated with the PS. In this study, the median duration of treatment was 77 weeks for TBS, 19 weeks for BS, and 13 weeks for PS. Adverse drug reactions (ADRs) should be monitored during treatment. Our results indicated that omadacycline and contezolid exhibited remarkable efficacy in the treatment of spinal infections. Conclusion Patients of spinal infections with diverse etiologies presented varied clinical features and risk factors, the treatment should be individualized. Due to the long course of treatment, ADRs need to be monitored during treatment, and newer drugs such as omadacycline and contezolid are efficacious and have favorable safety profiles.