Nurdan PÜR, Basri PÜR
Journal of Turkish Spinal Surgery - 2026;37(2):82-87
Objective: This study aimed to compare the clinical, laboratory, and radiological characteristics of spondylodiscitis caused by pyogenic microorganisms, Brucella spp., and Mycobacterium tuberculosis. Materials and Methods: Patients diagnosed with spondylodiscitis at a single-center between January 2014 and December 2024 were retrospectively reviewed. Contrast-enhanced magnetic resonance imaging (MRI) was performed in all cases during the diagnostic evaluation. Patients were categorized into three groups according to etiology: pyogenic spondylodiscitis (PSD), brucellar spondylodiscitis (BSD), and tuberculous spondylodiscitis (TSD). The diagnosis was established based on clinical presentation, laboratory findings, and MRI features and supported by microbiological and/or histopathological confirmation when available. Results: A total of 122 patients were included: 81 (66.4%) with PSD, 29 (23.8%) with BSD, and 12 (9.8%) with TSD. The mean age was significantly higher in the PSD group (p=0.009). Motor neurological deficits were more frequently observed in patients with TSD (p<0.001). Pre-treatment and follow-up C-reactive protein levels were significantly higher in the PSD group than those in the other groups (p<0.05). Lumbar involvement was the most common site across all groups. Abscess formation was observed most frequently in PSD, and paravertebral abscesses were the predominant type. Patients who underwent surgical treatment achieved high rates of clinical and laboratory remission. Antibiotic therapy was continued for at least six weeks in those who achieved remission. Conclusion: Clinical presentation, inflammatory response, and neurological involvement in spondylodiscitis vary according to the causative pathogen. Recognition of these etiology-related differences may facilitate earlier diagnosis and guide appropriate treatment strategies, thereby improving infection control and reducing the risk of neurological complications.
