Skip to main content

Advertisement

Log in

Diagnostic and therapeutic management of lumbar and thoracic spondylodiscitis – an evaluation of 59 cases

  • Original article
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Fifty-nine patients with spondylodiscitis (SD) of the thoracic and/or lumbar spine were followed-up clinically and radiologically [X-ray, computed tomography (CT), magnetic resonance imaging (MRI)] over a mean time of 2.2 years (1–6.5 years). All patients without abscess formation (n = 35) were treated conservatively. Out of the group with abscess formation (n = 24) 6 patients were also treated conservatively, 11 were drained under CT control and 7 were operated. At time of diagnosis, “signs of florid inflammation” were seen in 60% of the roentgenograms, in 93% of the CTs and in all of the MRIs. The sensitivity to differentiate between SD with and without abscess formation was 85% by MRI and 69% by CT. “Signs of regressive inflammation” and “signs of increasing osseous consolidation”, essential facts for starting remobilization, could first be seen using CT 6 weeks after onset of therapy. Using MRI these signs were seen with a considerable delay at 12 weeks. Clinically, only 3 of the 59 analyzed patients developed recurrent SD. In conclusion, MRI is the radiological method of choice for establishing the diagnosis of SD, in particular with regard to differentiating between cases with and without abscess formations. In contrast, CT is superior for performing success control after treatment. Therapeutically, conservative, minimal-invasive and operative procedures are not rival but rather complementary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Author information

Authors and Affiliations

Authors

Additional information

Received: 9 May 1999

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wirtz, D., Genius, I., Wildberger, J. et al. Diagnostic and therapeutic management of lumbar and thoracic spondylodiscitis – an evaluation of 59 cases. Arch Orth Traum Surg 120, 245–251 (2000). https://doi.org/10.1007/s004020050457

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004020050457

Navigation