Pos0066 Tuberculous, Brucellar and Pyogenic Spondylodiscitis: A Descriptive and Comparative Study in 115 Patients

Background: Infection spondylodiscitis is a serious infectious disease involveing intervertebral disc and its adjacent vertebral bodies. It may also extend into the the adjacent neural structures. Early diagnosis and identifing the causative agent seem to be crucial prognostic factors. Objectives: Through this study, we aim to describe then compare the clinical, biological and radiological features of tuberculous (TS), brucellar (BS) and pyogenic spondylodiscitis (PS). Methods: A retrospective monocentric study involving 115 cases of infectious spondylodiscitis admitted between January 2009 and August 2022 at our rheumatology department. Clinical, laboratory and radiological data of the patients were collected. Results: Among the 115 patients, 26 (22.8%) had TS, 18 (15.8 %) BS and 71 (61.4%) PS. There were 59 women (51.5 %) and 56 men (48.5%). The age of the patients ranged from 12 to 83 years, with a mean of (SD±) 55± 14,77 years. The patients with TS were younger than those with PS (p=0.0016). Of our cases, 62.60 % had comorbid chronic diseases such as predominantly renal failure and diabetes. The median diagnosic delay (MDD) in our series was 124,188 and 30 days for TS, BS and PS respectively. All of the patients included in this study suffered from pain, 71 of these had fever and 45 had night sweats. Radiculalgia was found in 41 % of cases and 3.4 % of them had a neurological defect. There were no significant differences in those clinical features between the groups. Laboratory findings showed increased erytrocyte sedimentation rate (ESR) was detected in 81.2 %, C-reactive protein (CRP) positivity in 86.1% and hyperleukocytosis in 33.7 % of patients. ESR and CRP levels were significantly higher in PS patients when compared with TS cases. Standard X-rays showed abnormalities suggestive of spondylodiscitis in 67.3 % of cases. Computed tomography and Spinal magnetic resonance imaging were performed respectively in 38.6 % and 92.1 % of cases and were pathological in all cases. A great majority of the patients had involvement at only one vertebrae level (68.3 %). The most frequently affected levels were the thoracic (33.3%), the lombosacral (100%) and the lombar (38.6%) segment in the TS, BS and PS respectively. In BS the lombosacral segment was significantly the most frequently affected level (p<0.003). The intervertebral disc narrowing was observed in 83.2% of patients. Abscesses and epidural masses were present respectively in 27.8% and 26.5 % of TS, versus 13 % and 11.76 % of BS, and 59 % and 61.7 % of PS, there were no significant differences between the groups. Conclusion: This study revealed a quite significant clinical, biological and radiological differences between TS, BS and PS. The presence of back pain, fever, moderate elevation of inflammatory markers with thoracic radiological involvement were suggestive of tuberculous spinal infection. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.