gms | German Medical Science

Objective: Spondylodiscitis is a rare but serious infection of the vertebra and intervertebral discs with an inflammatory, destructive course. The incidence is currently increasing due to a higher frequency of risk factors and comorbidities mainly associated with an increased life-expectancy. Management and treatment recommendations remain controversial. However, there has been a paradigm shift towards a surgical approach comprising debridement and instrumentation aiming to eradicate infection and enable early mobilisation of the patients. Despite the increasing experience in surgical treatment there is a lack of knowledge concerning long-term results of both conservative and surgical treatment in spondylodiscitis. Therefore the goal of this study was to analyze the long-term results in quality of life in these patients (QoL).

Method: All patients with spondylodiscitis treated in our hospital between 2009 and 2015 were included in this study. For evaluation of quality of life we recorded each patients satisfaction according to the Short-Form 36 Health Survey (SF-36) questionnaire. Physical and psychological Items were compared to a German standard population. The minimum follow-up was 6 month and the maximum follow-up was 6 years. Unpaired t test was performed for parametric statistics.

Results: 182 adult patients with spondylodiscitis were included in this study. 142 (78%) underwent surgery and 40 (22%) were treated conservatively. The mean overall age was 66 (30-98) years. 62 patients were female and 120 patients were male. The infection was located in the cervical spine in 40 patients (22%), thoracic spine in 52 patients (28%), and lumbar spine in 92 patients (50%). The items physical functioning (p< 0.013) and general health perception (p< 0.03) recorded with SF-36 were significantly better in the surgical group than in the conservative group, but did not reach the level of the normative sample. General mental health was significantly improved after surgery (p< 0.05) compared to the conservative cases and was even similar to the standard population.

Conclusions: The results of our study suggest that surgery is more beneficial than conservative treatment in patients with a spinal infection. After surgery the psychological condition was almost similar to the standard population.