Diagnosis and Treatment Options for Cervical Spondylodiscitis

Introduction Cervical spondylodiscitis can present through a variety of unspecific signs and symptoms usually associated with a delay diagnosis. The close anatomic relation of the infection process with the spinal cord at this mobile area leads to a serious medical situation. Its low incidence and the lack of papers with high level of evidence in the literature explain why there are no well-established treatment protocols. Our objective was to evaluate retrospectively the treatment of a consecutive series of 19 adult patients treated for cervical spondylodiscitis. Material and Methods 19 patients were evaluated with an average of 4 years of follow up. Eleven patients with a diagnosis of mechanical instability, neurologic compromise, or abscess formation were treated surgically; the remaining 8 were managed conservatively with external immobilization while all received intravenous antibiotics. Staphylococcus aureus, identified in 9 patients, was the most frequent etiologic agent. Results At final follow up all patients presented resolution of signs and symptoms of infection; a solid fusion was obtained in every case. In 5 patients with incomplete spinal cord compromise the remission was complete. Only 1 of the 5 patients with radicular compromise remains with paresthesias. Conclusion According to our selection guidelines, the combination of parenteral antibiotic treatment and external immobilization or surgery proved to be an adequate treatment in our small series of patients with cervical spondilodiscitis.