Retrospective examination of patients with infective spondylodiscitis followed in Bursa Uludağ University Medical Faculty Hospital infective diseases clinic and outpatient clinic between 2000-2020

Since the clinical findings of spondylodiscitis are not specific, there may be difficulties and delays in diagnosis. It is essential to treat the causative agent for the success of the treatment. In our study, the clinical manifestations, diagnostic methods and treatment options of patients with spondylodiscitis were examined and it was aimed to get an early diagnosis in order to reduce the morbidity of the patients and to determine effective treatment options. In our study, patients with a diagnosis of infectious spondylodiscitis aged 18 years and older who were followed up in the Infectious Diseases Clinic and Outpatient Clinic of Bursa Uludağ University Faculty of Medicine between January 1, 2000 and December 31, 2020 were evaluated retrospectively. Our study included 336 patients. Of the patients, 55 (16.4%) were diagnosed with tuberculous spondylodiscitis, 86 (25.6%) were diagnosed with brucellar spondylodiscitis, 195 (58%) were diagnosed with pyogenic spondylodiscitis. Of the pyogenic spondylodiscitis patients, 107 (n=195, 54.9%) were community-acquired, and 88 (n=195, 45.1%) had postoperative spondylodiscitis. The most common symptom among all groups was low back pain (77%). The most frequently affected vertebrae were thoracic vertebra (45.5%) in tuberculous spondylodiscitis, lumbar spine (51.1%) in brucellar spondylodiscitis and lumbar spine (53.8%) in pyogenic spondylodiscitis. It was found that interventional procedure was performed in 53 (96.3%) of 55 patients for the diagnosis of tuberculosis spondylodiscitis, histopathology supported the diagnosis in 32 (58%) of the patients and there was growth in the culture in 19 (34.5%) of them. Brucellar spondylodiscitis was diagnosed in 82 (93%) patients with brucella agglutination test and 12 (13.9%) patients with growth in culture. In the diagnosis of pyogenic spondylodiscitis, interventional procedures were performed in 94 (48.2%) of 195 patients, 83 (42.5%) patients were diagnosed with histopathology and 72 (36.9%) patients were diagnosed with growth in culture. The median duration of treatment was 450 days (240-1440 days) in tuberculous spondylodiscitis, 210 days (36-720 days) in brucellar spondylodiscitis and 150 days (15-960 days) in pyogenic spondylodiscitis. It was determined that surgical treatment was applied to 35 (63.6%) patients in tuberculous spondylodiscitis, 3 (3.5%) patients in brucellar spondylodiscitis and 72 (36.9%) patients in pyogenic spondylodiscitis. After the treatment, 204 (60.7%) of all patients recovered without sequelae. The diagnosis of spondylodiscitis requires the use of modern medical methods in suspected patients. It is important to determine the causative agent for an appropriate and sufficient duration of treatment. Keywords: Spondylodiscitis, tuberculosis, brucella, pyogenic, postoperative.