Pyogenic spondylitis

Twenty-nine patients with pyogenic vertebral osteomyelitis were reviewed re trospectively after an average follow-up of 3.7 years. We identified 17 pat ients 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 ha d neurological impairment at presentation. Eleven patients who were neurolo gically intact had needle biopsies and the remaining 18 patients who were n eurologically compromised had an open decompression. Staphylococcus aureus was cultured in 14 patients. Although spinal tuberculosis is relatively com mon in our environment it is important to obtain a tissue diagnosis in orde r to exclude pyogenic vertebral osteitis.