Study DesignReview article.ObjectivesA review of literature on the treatment of pyogenic spondylodiscitis in
geriatric patients was performed with the aim to give an overview about
these special patients and a recommendation on necessary diagnostics as well
as conservative and operative treatment options.MethodsA systematic computerized literature search was done by the spondylodiscitis
working group of the German Society for Orthopedics and Trauma Surgery.ResultsSpondylodiscitis has an increasing incidence by age with a peak at 75 years
or older. The 1-year mortality without an appropriate treatment is with 15
to 20% extremely high. Pathogen detection is the essential diagnostic step
and the basis for a sufficient antibiotic treatment. Geriatric patients have
initially less elevated inflammatory parameters. Compared to younger
patients. They have a longer length of hospital stay and take longer for CRP
normalization. Even the outcome between conservative and operative treatment
is comparable after one year. Patients with spinal instability, immobilizing
pain, epidural abscess, and newly emerged neurological deficits should be
considered for operative treatment.ConclusionsThe treatment of geriatric patients with pyogenic spondylodiscitis must take
into account that these patients usually have multiple comorbidities. The
main goals are resistance-based antibiotics and the shortest possible time
of immobilization of the patient.