POS0703 PYOGENIC AND NON-PYOGENIC SPONDYLODISCITIS: A COMPARATIVE STUDY
Authors: O. Neifar, O. Jomaa, R. Bougossa, S. Baccouche, M. Brahem, M. Ardhaoui, F. Larbi, M. Younes
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Infectious spondylodiscitis (IS) is an uncommon but severe infection of the spine that carries significant morbidity. It can be caused by a broad spectrum of germs. <h3>Objectives:</h3> Our study aims to compare the clinical, paraclinical and evolution features of this condition, in pyogenic and non-pyogenic spondylodiscitis (NPS). <h3>Methods:</h3> We carried out a retrospective descriptive study of patient records diagnosed with infectious spondylodiscitis in the rheumatology and Infectious diseases departments between 2012 and 2023. Cases where the causative germ was not identified were excluded. Patients were categorized into two groups: pyogenic and NPS. The socio-demographic, clinical, biological, radiological, and evolutionary data were compared. <h3>Results:</h3> Our study included 31 patients: 22 patients with pyogenic spondylodiscitis (PS) and 9 patients with NPS. The mean age in the two groups was 62.4 ± 15.3 and 58 ± 19.9, respectively, with no statistically significant difference (NSSD). The socio-demographic study showed a statistically significant differences (SSD) in marital status (p = 0.014), with NPS tending to be more prevalent in singles patients, and PS in married ones. Diabetes mellitus was statistically associated with PS (p = 0.05). The mean time to onset in the PS and NPS were respectively 59,2 ± 62.5 days and 87 ± 54 days, with NSSD. The clinical features study revealed that weight loss and night sweats were significantly more frequent in NPS (p = 0.015 and p =0.026). Inflammatory acute back pain was more common in the PS (p = 0.023). Paraspinal muscle spasm was more frequent in the NPS (p = 0.03). CRP levels were statistically higher in the PS group (p = 0.05). In the PS, isolated germs were identified as Staphylococcus (45.5%) and Gram-negative bacteria(27.7%).In the NPS, the detected germs were Tuberculosis (77.7%) and Brucella (22.2%). MRI showed a higher occurrence of epiduritis in the NPS (p = 0.005). CT-guided aspiration and biopsy were performed in 31.8% of PS and in 55.5% of NPS. It aided in the diagnosis of 28.5% and 80% of patients in each group, respectively. Neurological complications were noted in only 4.5% of the PS, with NSSD from the other group. Recovery after antibiotics was observed in 63.6% of PS versus 55.5% in the NPS. Persistent chronic back pain was found in 18.1% and 11.1% of patients, respectively, with NSSD. <h3>Conclusion:</h3> Our study demonstrated statistically significant differences between spondylodiscitis caused by pyogenic and non-pyogenic germs, particularly in terms of radiological complications and evolutionary modalities. Non-pyogenic spondylodiscitis exhibited a higher propensity for epiduritis, less frequent healing, and persistent long-term low back pain. It is essential to validate these findings through larger series for further reliability. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>