## 3 Results
### Pathogens and Identification Rates  
The studies included in this review reported a wide range of pathogens responsible for spondyloliscitis, with _Staphylococcus aureus_ being the most frequently identified organism, found in 53% of all studies that identified pathogens. While 8% of studies included only patients with monomicrobial infections, 85% explored polymicrobial cases or refractory infections (Table 2). The most frequently reported pathogens were _Staphylococcus aureus_[7; 10; 25; 26; 27; 20; 27], _Escherichia coli_[15; 25], and _Pseudomonas aeruginosa_[10; 28]. In many cases, methicillin-resistant _S. aureus_ (MRSA) was also reported, particularly in patients with more severe or refractory infections [16]. Other commonly identified pathogens included _Streptococcus_ species and, occasionally, fungal organisms such as _Candida_[10; 13]. Several studies also noted polymicrobial infections, which posed greater challenges in both diagnosis and treatment. The identification rates of pathogens varied between studies, ranging from 0.54 [18] to 0.9 [13], reflecting differences in diagnostic methods, sample sizes, and patient populations. These variations suggest the need for standardized diagnostic protocols to improve pathogen detection and tailor treatment strategies more effectively. Nevertheless, it should be emphasized that tuberculosis remains the most common cause of death due to an infectious, bacterial disease worldwide according to the World Health Organization [29], and the vertebral column is the most common site for osseeous involvement by tuberculosis. Although, in our country, spinal tuberculosis is not very common, a resurgence of this disease has also been observed in developed countries [30]. Thus, 75% of studies presented in our study show that Mycobacterium tuberculosis is the pivotal agent of spinal infections in spontaneous spinal infections observed in developed countries.  
\begin{table}
\begin{tabular}{p{113.8 pt} p{113.8 pt}} \hline \hline
**Author** & **Number of Identified Pathogens** & **Identification Rates** \\ \hline [PERSON] [10] & _S. aureus_—10, _P. aeruginosa_—2, _S. viridians_—2, _C. albicans_—1, _E. faecalis_—1, _M. tuberculosis_—1, _H. influenzae_—1 \\ \hline [PERSON] [9] & _D. acidovorants_—1, _E. coli_ (ESBL)—2, _S. aureus_—3, _S. anginosus_—1, _M. tuberculosis_ complex—1, _K. pneumoniae_—2, _C. albicans_—1 \\ \hline [PERSON] [11] & _S. aureus_—5, _E. coli_—1, _S. epidermidis_—1, _P. aeruginosa_—1, _S. viridians_—1, _M. tuberculosis_—1 \\ \hline [PERSON] [13] & _S. pyogenes_—2, _Staphylococcus_—2, _C. albicans_—2, _M. tuberculosis_ complex—1, _E. coli_—1, _S. maltophilia_—1, _Northuberculosis_—1, _Unidentified_—4 \\ \hline [PERSON] [15] & _S. aureus_—5, _S. epidermidis_—7, _E. faecalis_—2, _E. coli_—5, _K. pneumoniae_—3, Others—10, _Non-identified_—13 \\ \hline [PERSON] [16] & MRSA \\ \hline [PERSON] [17] & _S. aureus_—10, _S. aureus_ MRSA—11, _M. tuberculosis_—8, _E. Species_—9, _S. Species_—6, _G._ Gram-positive bacilli_—3, _P. aeruginosa_—2, _Fungal Infection_—3, _K. pneumoniae_—3, _P. micros_—3, _S. maltophilia_—3 \\ \hline [PERSON] [18] & 55\% \\ \hline [PERSON] [20] & _S. aureus_—12, _K. pneumoniae_—1, _S. hemolytic_—1, _S. plunimalium_—1 \\ \hline [PERSON] [21] & 70\% \\ \hline [PERSON] [13] & _S. pyogenes_—2, _Staphylococcus_—2, _C. albicans_—2, _M. tuberculosis_ complex—1, _E. coli_—1, _S. maltophilia_—1, _Northuberculosis_—1, _Unidentified_—4 \\ \hline [PERSON] [25] & _S. aureus_—8, _E. coli_—6 \\ \hline [PERSON] [26] & _S. aureus_—6, _P. aeruginosa_—2 \\ \hline \hline \end{tabular}
\end{table}
Table 2: Summary of identified pathogens and their identification rates.