Management of Spondylodiscitis
Diagnostic Approach
- MRI with and without contrast is the primary diagnostic modality for spinal infections, with 96% sensitivity, 94% specificity, and 92% accuracy 2, 3
- [18F]FDG PET/CT could be the preferred modality for detection of spondylodiscitis within 14 days of symptom onset 1, 4
- CT-guided biopsy is recommended when blood cultures are negative to establish microbiological diagnosis 3
- Monitor inflammatory markers (CRP and ESR) to assess disease activity and treatment response 1
Antimicrobial Therapy
- No relevant cited facts available
Surgical Management
- Surgical intervention is indicated in scenarios such as neurological deficits with spinal cord compression 3
Monitoring and Follow-up
- Regular monitoring of inflammatory markers (CRP and ESR) is essential to assess treatment response 1
- Follow-up MRI is recommended to evaluate treatment response, though imaging findings may normalize more slowly than clinical and laboratory parameters 3
- CT is useful for follow-up in patients with spinal instrumentation 2, 3
- Approximately 10% of cases may have non-contiguous multilevel infections, which should be considered during follow-up 1, 4