Infections rachidiennes de l’adulte autres que la spondylodiscite : l’envers des corps vertébraux

Abstract

Spinal infections other than vertebral osteomyelitis are mainly represented by facet joint septic arthritis (FJSA). The clinical presentation most often mimics vertebral osteomyelitis. The diagnosis is made by MRI, which sometimes shows abscesses of the adjacent soft tissues (muscular and epidural). Bacteriological documentation by blood cultures is usually sufficient, but a scan-guided puncture or even surgical management is sometimes necessary. Neurological deficit is the main complication of FJSA and requires urgent surgical management. Appropriate antibiotic therapy, most often against methicillin sensitive Staphylococcus aureus, is generally maintained for 6 to 12 weeks. The total duration of treatment is not recommended and depends on the presence or absence of a medically or surgically treated epidural abscess and the causative bacteria. Isolated and spontaneous epidural abscess is another spinal infection that can mimic the clinical presentation of spondylodiscitis and ASIA. Its management requires a surgical opinion, as it often leads to deficits.