DOI: 10.36347/sjams.2017.v05i12.078

Pages: 5215-5222

Background: Vertebral osteomyelitis and discitis are serious infections of the spine that can lead to significant morbidity if not managed appropriately. The optimal treatment approach surgical versus non-surgical is still debated, with differing outcomes based on infection severity and patient characteristics. Objective: To compare the clinical outcomes of surgical versus non-surgical treatment in patients with vertebral osteomyelitis and discitis, focusing on infection resolution, pain relief, functional recovery, complications, and treatment duration. Methods: A prospective observational study was conducted over one year, involving 100 patients diagnosed with vertebral osteomyelitis and discitis at multicenter hospitals. Patients were randomly assigned to two treatment groups: 50 patients in the non-surgical group (Group A) received broad-spectrum antibiotics and supportive care, while 50 patients in the surgical group (Group B) underwent surgical debridement and stabilization (if necessary) along with antibiotics. Outcomes, including infection control (CRP, ESR), pain relief (VAS), functional recovery (ODI), complications, and duration of hospital stay and antibiotic therapy, were assessed at baseline, 2, 6, and 12 weeks, and at follow-up visits. Results: The surgical group demonstrated significantly better infection resolution (94% vs. 82%, p=0.04) and a greater reduction in pain (45% reduction in VAS vs. 18%, p=0.02). Functional recovery, measured by the Oswestry Disability Index (ODI), was also superior in the surgical group (50% improvement vs. 27%, p<0.05). However, the surgical group had a higher complication rate (26%) compared to the non-surgical group (18%), though this difference was not statistically significant. Patients in the surgical group had a longer hospital stay, but required a shorter duration of antibiotic therapy (6-8 weeks vs. 8-12 weeks in the non-surgical group). Conclusion: Surgical intervention in vertebral osteomyelitis and discitis r