Spondylodiscitis

Abstract

Spondylodiscitis is a term that includes vertebral osteomyelitis, infection of the intervertebral disk and/or the soft tissues of the extradural spine. The most common route of infection is hematogenous spread from a distant infection focus and is considered primarily a monomicrobial infection, most frequently caused by Staphylococcus aureus Although the diagnostic suspicion is based on clinical, laboratory, and imaging fi ndings, defi nite diagnosis is achieved by bacteriological examination of the infected tissue. MRI is the most useful modality for any imaging spine infection, demonstrating bone marrow, endplate, and disk involvement and allowing the direct visualization of the neural structures. Sometimes non-pyogenic spondylitis, degenerative changes, dialysis spondyloarthropathy, and neuropathic spine are diffi cult to differentiate from pyogenic spondylitis and CT and radionuclide imaging are useful as adjunct techniques.