Pyogenic spondylitis

Twenty-nine patients with pyogenic vertebral osteomyelitis were reviewed retrospectively after an average follow-up of 3.7 years. We identified 17 patients with predisposing factors (10 diabetes, 4 urinary tract infection, 2 HIV-positive, 1 rheumatoid arthritis). No patient presented with a febrile illness. The lumbar spine was involved in 15 patients. Eighteen patients had neurological impairment at presentation. Eleven patients who were neurologically intact had needle biopsies and the remaining 18 patients who were neurologically compromised had an open decompression. Staphylococcus aureus was cultured in 14 patients. Although spinal tuberculosis is relatively common in our environment it is important to obtain a tissue diagnosis in order to exclude pyogenic vertebral osteitis.