Infective spondylodiscitis � An Indian Perspective

Nisha Jose; Ravikar Ralph; Thenmozhi Mani; Anand Zachariah

Volume : VI, Issue : VIII, August - 2016

Infective spondylodiscitis � An Indian Perspective

Nisha Jose, Ravikar Ralph, Thenmozhi Mani, Anand Zachariah

Abstract :

Introduction: Spondylodiscitis is a morbid illness resulting in neurological deficits in one third of individuals affected. Few studies have been done from India looking at the differences in the pathogen, course and outcome of this disease. This study aims at providing an Indian perspective to the epidemiology of this disease. Methods: A retrospective observational study was undertaken looking at data over the last 12 years (2003–2015) among all patients admitted as inpatients into the General Medicine ward in a tertiary level care hospital in South India, with a discharge diagnosis of infective spondylodiscitis from any cause. 61 patients were identified and followed up using electronic records of patient’s visits to the outpatient after discharge. The details of their clinical features and imaging findings were also retrieved from the online database of this hospital and analysed using SPSS 16 software. Results: Of 61 patients with infective spondylodiscitis, 35 were of tuberculous origin, 23 were of pyogenic origin and 2 were fungal. In one patient no microbe was identified. The time to presentation was significantly different in the two groups with tuberculosis having an average of 6 months vs. only 1 month in the pyogenic group. Back pain was the predominant symptom. MRI had an almost similar appearance in both pyogenic and tuberculous infection offering few distinguishing features between the two. Percutaneous biopsy was done in large number of patients and proved a useful tool to diagnosis Conclusions: Spondylodiscitis in the India shows a different microbiological profile with tuberculosis being the commonest etiology followed by Staphylococcal infections. The time to presentation is longer than seen in western data. MRI of the spine offers little differentiation between tuberculous and pyogenic infection in comparison to western data. The majority of patients underwent medical treatment with surgery being used in only a small number of individuals. While the mortality is less than in literature, the morbidity of neurological deficit is similar