AB0937 COMPARATIVE STUDY OF PYOGENIC SPONDYLODISCITIS VERSUS TUBERCULOUS SPONDYLODISCITIS

Background:Infectious spondylodiscitis is a life-threatening infection of the intervertebral disc and adjacent vertebrae that can be caused by a variety of microorganisms. Our country is at intermediate endemicity for Tuberculosis.Objectives:To compare the clinical, biological, radiological characteristics, management and prognosis of pyogenic versus tuberculous spondylodiscitis.Methods:Retrospective study of 89 patients admitted to our department over a period of 20 years [1998-2018]. The diagnosis of spondylodiscitis was made based on clinical, biological, radiological and bacteriological data.Results:The average age of the patients was 56.1 years. There were 46 men (51.6%) and 43 women (48.4%) with a female predominance during tuberculous spondylodiscitis (57.1%) versus 26.9% during pyogenic spondylodiscitis (p = 0.009).Diabetes was more frequent during pyogenic spondylodiscitis but with no statistically significant difference (p = 0.4). The evolution time was statistically greater during tuberculous spondylodiscitis (p Hyperleukocytosis was noted more frequently in the pyogenic group than in the tuberculosis group (p=0.03), while the increase in sedimentation rate was not significantly different between the two groups (90 mm/h and 76 mm/h, respectively, p=0.1). We found no statistically significant difference regarding the site of spondylodiscitis.Radiologically, the frequency of para-vertebral and psoas abscesses, epiduritis and the presence of spinal cord compression were similar in the two groups (p=0.2; p=0.1 and p=0.1, respectively), whereas mirrored geodes were more frequent during tuberculosis (p = 0.04).Surgical and interventional treatments (percutaneous sampling, abscess drainage) were more frequently noted during pyogenic spondylodiscitis, but without significant difference (p=0.2). The occurrence of immediate complications was more frequent during tuberculosis but without a statistically significant difference (p=0.2).Conclusion:In our series, patients with tuberculous spondylodiscitis tend to have a chronic pattern of progression and more often an impaired general condition. However, there was no significant difference in the presence of abscess, epiduritis and the occurrence of complications between tuberculous spondylodiscitis and pyogenic spondylodiscitis.Disclosure of Interests:None declared