Adult Pyogenic Vertebral Osteomyelitis (spondylodiskitis)

Question 1

What are risk factors for sponylodiskitis?

Answer 1

1) IV drug abuse
2) DM
3) recent systemic infection (UTI)
4) malignancy or immunocompromised
5) smoker

Question 2

How does vertebral osteomyelitis present radiographically?

Answer 2

Disc space narrowing at 7 days
Endplate erosion and sclerosis at 10-21 days (malignancies usually spare the disc)
MRI 96% sen, 93% spec
Bone scan can be used; Tc99 with gallium 67

Question 3

How is vertebral osteo treated?

Answer 3

Usually IV abx is sufficient (80%); if fails can do anterior debridement with posterior instrumentation