Medical and surgical management of non- pyogenic spontaneous spondylodiscitis

Non-pyogenic spontaneous spondylodiscitis, although most commonly casued by tuberculosis, can be caused by brucellosis and a variety of fungi including aspergillus, coccidioides and candida. Direct aspiration or tissue biopsy is usually necessary to identify the causative organism. An appropriate antibiotic treatment for the likely offending organism is proposed. Surgical treatment is reserved for unstable spinal segment or marked kyphosis in the face of any neurologic deficit. Surgical approaches are dictated by the anatomic location of the offendnig lesion