Spondylodiscitis or spondylitis refers to an inflammatory and/or infectious process of vertebral disk and contiguous vertebral bodies. The lumbar vertebrae are most commonly involved (45%), followed by thoracic vertebrae (35%).
Clinical manifestations may be acute or subacute, depending of the aggressiveness of the microorganism, immunological response and host age. There is commonly an inordinate delay between symptom onset and diagnosis.
Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus bovis, Streptococcus sanguis, Streptococcus pyogenes and Enterococcus faecalis are common pathogen. The infection occur most often from haematogenous seeding. Retrograde spread of infection is purported to occur from a urinary tract or pelvic source such as prostatitis.
Blood cultures should be obtained but often are negative. Needle biopsy is essential to substantiate the diagnosis and provide culture material if blood cultures are negative.
The incidence of spondylitis is highest in adult 50 years of age and older. Risk factors include cancer, diabetes and corticoid use.