Document Type
Article
Publication Date
4-1-2025
Abstract
Study DesignLiterature Review with clinical recommendations.ObjectiveTo highlight impactful studies on pyogenic spondylodiscitis (PS), identified by the AO Spine Knowledge Forum Trauma and Infection, with recommendations for their integration into clinical practice.MethodsFive influential studies on PS that have the potential to shape current practice in spinal infections were selected and reviewed. Each study was chosen for its contribution to a critical phase in PS management: diagnosis, imaging, surgical vs conservative treatment, and antibiotic duration. Recommendations were graded as strong or conditional following the GRADE methodology.ResultsFive studies were highlighted. Article 1: Pluemer et al introduced the Spinal Infection Treatment Evaluation (SITE) Score, a novel scoring tool for standardizing treatment decision-making. Conditional recommendation to incorporate the SITE Score or SISS Score for improved treatment outcomes. Article 2: Maamari et al conducted a meta-analysis comparing imaging modalities, with conditional recommendation to consider 18F-FDG PET/CT to diagnosis PS as an adjunct to MRI which remains the gold standard. Article 3: Thavarajasingam et al demonstrated the potential survival benefit of early surgery in specific PS cases, leading to a strong recommendation for early intervention in appropriate patients. Article 4: Neuhoff et al compared conservative and surgical treatments in well-resourced settings, concluding a strong recommendation for early surgery in appropriate patients. Article 5: Bernard et al evaluated antibiotic treatment duration, with a conditional recommendation for a 6-week course in confirmed cases, based on comparable efficacy to a 12-week regimen.Conclusions Management of PS remains complex and varied. This perspective provides spine surgeons with evidence-based recommendations to enhance standardization and effectiveness in clinical practice.
Recommended Citation
Bigdon, Sebastian F.; Vialle, Emiliano; Dandurand, Charlotte; Scherer, Julian; Camino-Willhuber, Gaston; Joaquim, Andrei F.; Chhabra, Harvinder S.; El-Sharkawi, Mohammad; Bransford, Richard; Fisher, Charles G.; Schnake, Klaus J.; and Schroeder, Gregory D., "Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Evaluation and Treatment of Pyogenic Spondylodiscitis of the Spine: AO Spine Knowledge Forum Trauma and Infection" (2025). Rothman Institute Faculty Papers. Paper 282.
https://jdc.jefferson.edu/rothman_institute/282
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Language
English
Included in
Bacterial Infections and Mycoses Commons, Orthopedics Commons, Other Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons
Comments
This article is the author's final published version in Global Spine Journal, Volume 15, Issue 3, April 2025, Pages 1490 - 1497.
The published version is available at https://doi.org/10.1177/21925682251316814.
Copyright © The Author(s)