Epidemiology and management of infectious spondylitis in Korea: a narrative review
Infectious spondylitis, an infection of the vertebral body, intervertebral disc, or paraspinal tissues, poses diagnostic and therapeutic challenges. This review examines the clinical approach and management of infectious spondylitis in Kore...
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| Format: | Article |
| Language: | English |
| Published: |
Ewha Womans University College of Medicine
2024-07-01
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| Series: | The Ewha Medical Journal |
| Subjects: | |
| Online Access: | http://www.e-emj.org/archive/view_article?pid=emj-47-3-37 |
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| Summary: | Infectious spondylitis, an infection of the vertebral body, intervertebral disc,
or paraspinal tissues, poses diagnostic and therapeutic challenges. This review
examines the clinical approach and management of infectious spondylitis in
Korea. The incidence of pyogenic spondylitis has increased, primarily due to the
aging population, more frequent use of invasive procedures, and higher
prevalence of immunocompromising conditions. Conversely, tuberculous spondylitis
has declined, reflecting shifts in population demographics and medical
practices. Staphylococcus aureus remains the predominant
causative agent in pyogenic cases, while Mycobacterium
tuberculosis is the primary pathogen in tuberculous spondylitis.
The diagnosis is contingent upon clinical suspicion, inflammatory markers,
imaging studies, and microbiological identification. MRI is the preferred
imaging modality, offering high sensitivity and specificity. Blood cultures and
tissue biopsy are instrumental in isolating the causative organism and
determining its antibiotic susceptibility. Treatment involves antimicrobial
therapy, spinal immobilization, and vigilant monitoring for complications.
Surgical intervention may be necessary in cases involving neurological deficits,
abscesses, or spinal instability. The prognosis for infectious spondylitis
varies. Long-term complications, including chronic pain, neurological deficits,
and spinal deformities, may arise and can meaningfully impact quality of life.
Mortality is considerable and is influenced by comorbidities and disease
severity. The risk of recurrence, particularly within the first year after
treatment, is a concern. This review underscores the importance of ongoing
research and education in refining diagnostic and treatment strategies for
infectious spondylitis. As this condition becomes more common, these efforts
offer hope for improving patient care and reducing the burden of this severe
spinal infection. |
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| ISSN: | 2234-2591 |