Observational studyBMC infectious diseases2025
The clinical characteristics and outcomes of anaerobic spondylodiscitis: a retrospective observational study.
Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPyogenic spondylodiscitis is rarely caused by anaerobic organisms. This retrospective study evaluated the clinical manifestations and treatment outcomes in patients affected by anaerobic spondylodiscitis.
methodsWe performed a retrospective analysis of medical records from individuals diagnosed with anaerobic spondylodiscitis between January 2018 and January 2024.
resultsFrom January 2018 to January 2024, 373 cases of pyogenic spondylodiscitis were identified in our department. Twenty-three patients (6.2%; 16 males and 7 females), with a mean age of 63.7 years (63.7 ± 14.3 years), were diagnosed with anaerobic spondylodiscitis during this period. All patients presented with persistent back pain lasting over one month, 5 patients (21.7%) had fever, and 3 patients (13.0%) had sciatica. The lumbar spine affected 18 patients (78.3%), and the thoracic spine affected 5 (21.7%) patients. Computed tomography images usually reveal erosion and destruction of adjacent endplates and vertebral bodies. T1-weighted Magnetic resonance imaging revealed a reduction in the signal intensity of the vertebral body, endplate and intervertebral disc. T2-weighted images demonstrate increased signal intensity of the vertebral body and/or disc. Cultures of specimens obtained by percutaneous fluoroscopically guided biopsy or surgery were positive for pathogens for 10 (43.5%) of 23 patients, and Next-generation sequencing (NGS) was positive for 19 (95.0%) of 20 patients. The positive rate of NGS is higher than that of cultures (P<0.01). The most common gram-positive coccus is Parvimonas micra, and the gram-negative bacilli is Bacteroid fragilis. One patient (number 1) treated with a 6-week course of antibiotics relapsed 1 month after treatment withdrawal. There was no statistically significant variation in the cure rate between the conservative treatment group and the surgical treatment group (P > 0.05).
conclusionsThe incidence of anaerobic spondylodiscitis might be underestimated, as it is difficult to recover anaerobic bacteria. Next-generation sequencing demonstrated superior diagnostic accuracy for anaerobic pathogen identification compared to traditional culture methods. Anaerobic spondylodiscitis generally exhibits a favorable prognosis, considering that appropriate antibiotic therapy is administered and suitable surgical treatment is performed if necessary. CLINICAL TRIAL NUMBER: Not applicable.
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